TY - JOUR
T1 - Association of daptomycin dosing regimen and mortality in patients with VRE bacteraemia
T2 - A review
AU - Foolad, Farnaz
AU - Taylor, Brandie D.
AU - Shelburne, Samuel A.
AU - Arias, Cesar A.
AU - Aitken, Samuel L.
N1 - Funding Information:
C. A. A.: speakers’ bureaus for Allergan, Pfizer, Merck and The Medicines Company; grants from Allergan, Pfizer, Merck and The Medicines Company; and advisory boards for Theravance, Merck, The Medicines Company and Bayer Global. S. L. A.: speakers’ bureau for Merck; and advisory boards for The Medicines Company. All other authors: none to declare.
Publisher Copyright:
© 2018 The Author(s). Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All Rights Reserved.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - VRE are associated with ∼1300 deaths per year in the USA. Recent literature suggests that daptomycin, a cyclic lipopeptide antibiotic with concentration-dependent bactericidal activity, is the preferred treatment option for VRE bacteraemia, yet the optimal dosing strategy for this indication has not been established. In vitro evidence suggests that higher-than-labelled doses of daptomycin are required to optimally treat VRE bacteraemia and to inhibit the development of resistance. However, concern of dose-dependent toxicities, notably increases in creatine phosphokinase and the development of rhabdomyolysis, are a barrier to initiating high-dose schemes in clinical practice. Thus, the effectiveness and safety of high-dose daptomycin regimens in clinical practice have remained unclear. While early studies failed to identify differences in mortality, newer, larger investigations suggest high-dose (≥9mg/kg) daptomycin is associated with reduced mortality in patients with VRE bacteraemia compared with standard (6mg/kg) dosing regimens. Additionally, the high-dose regimens appear to be safe and may be associated with improved microbiological outcomes. The purpose of this review is to examine the published evidence on the effectiveness and safety of high-dose daptomycin compared with standard dosing regimens for VRE bacteraemia.
AB - VRE are associated with ∼1300 deaths per year in the USA. Recent literature suggests that daptomycin, a cyclic lipopeptide antibiotic with concentration-dependent bactericidal activity, is the preferred treatment option for VRE bacteraemia, yet the optimal dosing strategy for this indication has not been established. In vitro evidence suggests that higher-than-labelled doses of daptomycin are required to optimally treat VRE bacteraemia and to inhibit the development of resistance. However, concern of dose-dependent toxicities, notably increases in creatine phosphokinase and the development of rhabdomyolysis, are a barrier to initiating high-dose schemes in clinical practice. Thus, the effectiveness and safety of high-dose daptomycin regimens in clinical practice have remained unclear. While early studies failed to identify differences in mortality, newer, larger investigations suggest high-dose (≥9mg/kg) daptomycin is associated with reduced mortality in patients with VRE bacteraemia compared with standard (6mg/kg) dosing regimens. Additionally, the high-dose regimens appear to be safe and may be associated with improved microbiological outcomes. The purpose of this review is to examine the published evidence on the effectiveness and safety of high-dose daptomycin compared with standard dosing regimens for VRE bacteraemia.
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U2 - 10.1093/jac/dky072
DO - 10.1093/jac/dky072
M3 - Review article
C2 - 29547977
AN - SCOPUS:85049179046
SN - 0305-7453
VL - 73
SP - 2277
EP - 2283
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
IS - 9
ER -