Pharmacodynamics of daptomycin in combination with other antibiotics for the treatment of enterococcal bacteraemia

Vista sencilla de ítem
dc.contributor.authorAvery, Lindsay M.
dc.contributor.authorKuti, Joseph L.
dc.contributor.authorWeisser, Maja
dc.contributor.authorEgli, Adrian
dc.contributor.authorRybak, Michael J.
dc.contributor.authorZasowski, Evan J.
dc.contributor.authorArias, Cesar A.
dc.contributor.authorContreras, German A.
dc.contributor.authorChong, Pearlie P.
dc.contributor.authorAitken, Samuel L.
dc.contributor.authorDiPippo, Adam J.
dc.contributor.authorWang, Jann-Tay
dc.contributor.authorBritt, Nicholas S.
dc.contributor.authorNicolau, David P.
dc.date.accessioned2020-05-14T19:23:23Z
dc.date.available2020-05-14T19:23:23Z
dc.date.issued2019
dc.description.abstractenglishDaptomycin is commonly prescribed in combination with other antibiotics for treatment of enterococcal bacteraemia. Whilst a free drug area under the concentration–time curve to minimum inhibitory concentration (fAUC/MIC) ratio >27.4 is associated with 30-day survival with daptomycin monotherapy, it is unknown whether receipt of other antibiotics affects this threshold. Data were pooled from seven published trials assessing outcomes in daptomycin-treated enterococcal bacteraemia, including patients receiving daptomycin (≥72 h) and any β-lactam, intravenous aminoglycoside, linezolid, tigecycline and/or vancomycin. Exposures were calculated using a published population pharmacokinetic model based on creatinine clearance, 90% protein binding and daptomycin Etest MIC. The fAUC/MIC threshold predictive of 30-day survival was determined by classification and regression tree analysis. Following pooling of data, 240 adults were included; 137 (57.1%) were alive at 30 days. A majority of patients were immunosuppressed (65.8%) and received a β-lactam (94.6%). Examining the threshold in low-acuity patients (n = 135) to control for co-morbidities, these patients were more likely to survive when fAUC/MIC >12.3 was achieved (63.2% vs. 20.0%; P = 0.015). The difference remained significant in a multivariable logistic regression model that controlled for infection source and immunosuppression (P = 0.017). This threshold is 2-fold lower than that observed with daptomycin monotherapy. Probabilities of threshold attainment using a 10 mg/kg/day dose were 100% for isolates with MICs ≤ 2 mg/L and 95.2% for a 12 mg/kg/day dose for MICs of 4 mg/L. These data support the use of high-dose daptomycin in combination with another antibiotic for treatment of enterococcal bacteraemia.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1016/j.ijantimicag.2019.07.002
dc.identifier.issn0924-8579
dc.identifier.urihttps://hdl.handle.net/20.500.12495/2785
dc.language.isoeng
dc.publisherElsevierspa
dc.publisher.journalInternational Journal of Antimicrobial Agentsspa
dc.relation.ispartofseriesInternational Journal of Antimicrobial Agents, 0924-8579, Vol 54, Num 3, 2019 pag 346-350spa
dc.relation.urihttps://www.sciencedirect.com/science/article/abs/pii/S0924857919301827
dc.rights.creativecommons2019
dc.rights.localAcceso cerradospa
dc.subject.decsBacteriasspa
dc.subject.decsInfeccionesspa
dc.subject.decsFarmacocinéticaspa
dc.subject.keywordsDaptomycinspa
dc.subject.keywordsPharmacodynamicsspa
dc.subject.keywordsEnterococcusspa
dc.subject.keywordsBacteraemiaspa
dc.subject.keywordsCombination therapyspa
dc.titlePharmacodynamics of daptomycin in combination with other antibiotics for the treatment of enterococcal bacteraemiaspa
dc.title.translatedPharmacodynamics of daptomycin in combination with other antibiotics for the treatment of enterococcal bacteraemiaspa
dc.typearticlespa
dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.type.localartículospa

Archivos

Bloque original
Mostrando 1 - 1 de 1
No hay miniatura disponible
Nombre:
Avery, Lindsay M..pdf
Tamaño:
646.26 KB
Formato:
Adobe Portable Document Format
Descripción:
Descargar

Colecciones

Artículos