Daptomycin use in patients with osteomyelitis: a preliminary report from the EU-CORE(SM) database.

Abstract

BACKGROUND:

Osteomyelitis is a complex and heterogeneous group of infections that require surgical and antimicrobial interventions. Because treatment failure or intolerance is common, new treatment options are needed. Daptomycin has broad Gram-positive activity, penetrates bone effectively and has bactericidal activity within biofilms. This is the first report on clinical outcomes in patients with osteomyelitis from the multicentre, retrospective, non-interventional European Cubicin(®) Outcomes Registry and Experience (EU-CORE(SM)), a large database on real-world daptomycin use.

PATIENTS AND METHODS:

In total, 220 patients were treated for osteomyelitis; the population was predominantly elderly, with predisposing baseline conditions such as diabetes and chronic renal/cardiac diseases.

RESULTS:

Most patients (76%) received prior antibiotic treatment, and first-line treatment failure was the most frequent reason to start daptomycin. Common sites of infection were the knee (22%) or hip (21%), and the most frequently isolated pathogens were Staphylococcus aureus (33%) and coagulase-negative staphylococci (32%). Overall, 52% of patients had surgery, 55% received concomitant antibiotics and 29% received a proportion of daptomycin therapy as outpatients. Clinical success was achieved in 75% of patients. Among patients with prosthetic device-related osteomyelitis, there was a trend towards higher success rates if the device was removed. Daptomycin was generally well tolerated.

CONCLUSIONS:

This analysis suggests that daptomycin is an effective and well-tolerated treatment option for osteomyelitis and highlights the importance of optimal surgical intervention and appropriate microbiological diagnosis for clinical outcomes.

• Authors: R Andrew Seaton, Konstantinos N Malizos, Pierluigi Viale, Panagiotis Gargalianos-Kakolyris, Teresa Santantonio, Enzo Petrelli, Rashidkhan Pathan, Markus Heep, Ricardo L Chaves
• Journal: The Journal of antimicrobial chemotherapy (J Antimicrob Chemother) Vol. 68 Issue 7 Pg. 1642-9 (Jul 2013) ISSN: 1460-2091 [Electronic] England
• PMID: 23515247 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Daptomycin

Topics

• Adult
• Aged
• Aged, 80 and over
• Anti-Bacterial Agents (therapeutic use)
• Daptomycin (therapeutic use)
• Female
• Gram-Positive Bacteria (isolation & purification)
• Gram-Positive Bacterial Infections (drug therapy, microbiology)
• Humans
• Male
• Middle Aged
• Osteomyelitis (drug therapy, microbiology)
• Retrospective Studies
• Treatment Outcome