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DI-060 Daptomycin: a drug use review at a general hospital
  1. EM Martin Gozalo1,
  2. L Prieto Borja2,
  3. G Toledano Mayoral1,
  4. MA Arias Moya1,
  5. M Hernandez Segurado1,
  6. M Bonilla Porras1,
  7. E Castillo Bazan1,
  8. J Becares Martinez1,
  9. M Gomez Perez1,
  10. MI Panadero Esteban1,
  11. B Rodriguez Vargas1,
  12. E Tortajada Esteban1
  1. 1Hospital Universitario Fundación Jimenez Diaz, Pharmacy, Madrid, Spain
  2. 2Hospital Universitario Fundación Jimenez Diaz, Microbiology, Madrid, Spain

Abstract

Background Daptomycin’s licensed indications are complicated skin and soft tissue infections (cSSTI), right-sided endocarditis due to Staphylococcus aureus (SA) and bacteraemia associated with emerging infectious diseases [EID] or cSSTI. Vancomycin should be used before daptomycin if possible.

Purpose To check the suitability of daptomycin against the indications licensed in the product information and also against Treatment Guidelines consensuses from different medical societies.

Materials and methods Retrospective observational study. We studied patients treated with daptomycin (January 2012 – December 2012) at a general hospital in its different units. Information was obtained from the Pharmacy’s Service records, the patient history and the Microbiology database

Results We studied 32 patients with the following distribution: 10 Intensive Unit Care, 10 pulmonary disease, 4 traumatology, 2 gastrointestinal surgery, 4 cardiology and 2 internal medicine.

In the intensive care medical unit, 90% were empirical treatments. 90% were adjusted to labelled indications. Daptomycin-sensitive microorganisms were isolated in 20% of the blood cultures and samples were negative or held non-susceptible organisms for the rest. Minimum Inhibitory Concentration (MIC) of vancomycin was requested in 4 patients, with a score of <0.5 but no one was given vancomycin as an alternative.

In the other units: 83.36% were given empirical treatments, in 4 patients (15%) blood cultures were not requested. In 3 patients (16.64%), it was not requested until the beginning of daptomycin treatment. SA was growing in 6 patients’ cultures (36.36%); the rest of them were negative or had daptomycin-resistant microorganisms. Vancomycin’s MIC was requested for 11 patients (50%), 4 of them had been previously treated with vancomycin. In the rest of them, vancomycin`s MCI was <1 but they were not treated with it.

Conclusions Treatment is essentially empirical, treatment guidelines for infections caused by SA are not followed. It is recommended to treat the patient with daptomycin if vancomycin’s MIC is > 1.5 or if patients have previously been treated with it.

No conflict of interest.

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