Background Daptomycin is an antibiotic only active against Gram-positive bacteria, with rapid bactericidal activity, a concentration-dependent and post-antibiotic effect. Indicated for complicated skin or soft tissue infections in adults (cSSTI), right side endocarditis due to Staphylococcus aureus and S. aureus bacteraemia associated with right-side infective endocarditis.
Purpose To perform a retrospective observational study of the use and effectiveness of daptomycin in our hospital.
Materials and Methods We extracted from the hospital computer system (SAP) prescribing data about daptomycin from January to December 2011. The data collected included age, sex, history number, diagnosis, causative organism, prescriber service, treatment duration and reason for suspension.
Results Were treated 85 patients (69% male) with an average age of 63.3 years (range 22–86 years). The average duration of treatment was 20.5 days. Prescribers’ services were: cardiac surgery/cardiology (27%), UCI (15%), haematology (12%), internal medicine (12%), nephrology (12%) and others (22%). The diagnoses for which daptomycin was used were: 32% endocarditis, 32% cSSTI, 20% bacteraemia, 11% osteoarticular infection and 5% others. Microorganisms identified were: 11% methicillin-resistant S. aureus (MRSA), 20% coagulase-negative Staphylococcus, 5% others and 64% was empirical treatment. In 36.5% of prescriptions, daptomycin was used as second-line antibiotic treatment, either because the patient did not respond to previous antibiotic treatment (32%) or due to side effects (39% anaemia with linezolid and 29% renal damage with vancomycin). The reasons for suspending daptomycin were: 77% for improvement/patient discharge or who ended treatment or switched to oral treatment, 9% change in treatment and 14% deceased.
Conclusions In 84% of cases the prescription complied with the authorised indications in datasheet. Daptomycin was prescribed first-choice in 63.5% of treatments. In 64% of case treatment was empirical without subsequent confirmation of the causative organism. It is necessary to establish a mechanism to decrease the rate of use of this antibiotic in the hospital for frontline empirical treatments.
No conflict of interest.
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