Abstract
Infective endocarditis (IE) is a serious form of infection with a high mortality. Medical management can be a challenge because of organ dysfunction, lack of clinical response or allergy to the recommended antibiotics. Daptomycin is a lipopeptide antibiotic with a potent bactericidal activity against Gram-positive bacteria. There are limited data on the use of daptomycin in complicated cases of IE. We aim to report our experience of daptomycin use in complicated cases of IE through a prospective observational study (from 1 October 2008 to 30 September 2009). Daptomycin was prescribed for cases that were either unresponsive or allergic to the standard therapy. Clinical characteristics and outcomes were reviewed. Success was defined as clinical improvement accompanied with the resolution of laboratory markers of sepsis and continuation of the above findings for at least 8 weeks after the end of therapy. Eight cases were evaluable. Native and prosthetic valves were involved in equal proportions. The range of organisms was wide: Staphylococcus aureus, two cases; S. epidermidis, two cases; streptococci, two cases; and Enterococcus faecalis, two cases. The median duration of therapy was 42 days. All patients were successfully treated. Daptomycin was well tolerated. Daptomycin is useful in the management of complicated cases of IE.
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References
Murdoch DR, Corey GR, Hoen B, Miró JM, Fowler VG Jr, Bayer AS et al (2009) Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis—Prospective Cohort Study. Arch Intern Med 169:463–473
Elliott TSJ, Foweraker J, Gould FK, Perry JD, Sandoe JAT (2004) Guidelines for the antibiotic treatment of endocarditis in adults: report of the Working Party of the British Society for Antimicrobial Chemotherapy. J Antimicrob Chemother 54:971–981
Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I et al (2009) Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC) for Infection and Cancer. Eur Heart J 30:2369–2413
Baddour LM, Wilson WR, Bayer AS, Fowler VG Jr, Bolger AF, Levison ME et al (2005) Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. Circulation 111:e394–e434
Sakoulas G, Moise-Broder PA, Schentag J, Forrest A, Moellering RC Jr, Eliopoulos GM (2004) Relationship of MIC and bactericidal activity to efficacy of vancomycin for treatment of methicillin-resistant Staphylococcus aureus bacteremia. J Clin Microbiol 42:2398–2402
Pillai SK, Wennersten C, Venkataraman L, Eliopoulos GM, Moellering RC, Karchmer AW (2009) Development of reduced vancomycin susceptibility in methicillin-susceptible Staphylococcus aureus. Clin Infect Dis 49:1169–1174
LaPlante KL, Woodmansee S (2009) Activities of daptomycin and vancomycin alone and in combination with rifampin and gentamicin against biofilm-forming methicillin-resistant Staphylococcus aureus isolates in an experimental model of endocarditis. Antimicrob Agents Chemother 53:3880–3886
Fowler VG Jr, Boucher HW, Corey GR, Abrutyn E, Karchmer AW, Rupp ME et al (2006) Daptomycin versus standard therapy for bacteremia and endocarditis caused by Staphylococcus aureus. N Eng J Med 355:653–665
Bhavnani SM, Prakhya A, Hammel JP, Ambrose PG (2009) Cost-effectiveness of daptomycin versus vancomycin and gentamicin for patients with methicillin-resistant Staphylococcus aureus bacteremia and/or endocarditis. Clin Infect Dis 49:691–698
Li JS, Sexton DJ, Mick N, Nettles R, Fowler VG Jr, Ryan T et al (2000) Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis 30:633–638
Rand KH, Houck HJ (2004) Synergy of daptomycin with oxacillin and other beta-lactams against methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 48:2871–2875
Levine DP (2008) Clinical experience with daptomycin: bacteraemia and endocarditis. J Antimicrob Chemother 62(Suppl 3):iii35–iii39
Hill EE, Herregods MC, Vanderschueren S, Claus P, Peetermans WE, Herijgers P (2008) Management of prosthetic valve infective endocarditis. Am J Cardiol 101(8):1174–1178
Sakoulas G, Alder J, Thauvin-Eliopoulos C, Moellering RC Jr, Eliopoulos GM (2006) Induction of daptomycin heterogeneous susceptibility in Staphylococcus aureus by exposure to vancomycin. Antimicrob Agents Chemother 50:1581–1585
Acknowledgements
We thank the Health Protection Agency (reference laboratory) Colindale, London, UK, for carrying out the molecular identification on the explanted cardiac valves and tissues through 16S r DNA PCR (for patient no. 2).
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No funding was received for this work. The data were generated as part of routine work.
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Ethical approval was not necessary as this was a part of a routine observational study.
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Das, I., Saluja, T. & Steeds, R. Use of daptomycin in complicated cases of infective endocarditis. Eur J Clin Microbiol Infect Dis 30, 807–812 (2011). https://doi.org/10.1007/s10096-011-1160-y
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DOI: https://doi.org/10.1007/s10096-011-1160-y