A retrospective clinical comparison of daptomycin vs daptomycin and a beta-lactam antibiotic for treating vancomycin-resistant Enterococcus faecium bloodstream infections.

ABSTRACT: There is limited clinical evidence to support the combination of daptomycin and beta-lactam antibiotics (DAP?+?BLA) for treatment of vancomycin-resistant enterococci (VRE) bloodstream infections (BSI). We conducted a prospective observational cohort study of VRE-BSI during 2010-2015. The primary endpoint was mortality at the end of treatment. We included 114 patients who received DAP for VRE-BSI. Of these 87 (76.3%) received DAP?+?BLA. There were no significant differences in mortality between the DAP and DAP?+?BLA groups on univariable analysis (10/27 vs. 34/87, P?=?0.85). A subgroup analysis of patients with enterococcal DAP minimum inhibitory concentrations (MICs)??2?mg/L, revealed that those treated with DAP?+?BLA had a lower mortality (adjusted hazard ratio [aHR], 0.23; 95% confidence interval [CI], 0.06-0.93; P?=?0.04) after adjustment for other significant predictors of mortality, including the DAP dose. In addition, patients receiving high-dose (?9?mg/kg) DAP?+?BLA independently had a better survival than those receiving low-dose DAP alone (aHR?=?5.16), low-dose DAP?+?BLA (aHR?=?5.39), and high-dose DAP alone (aHR?=?19.01) (P?

SUBMITTER: Chuang YC 

PROVIDER: S-EPMC5786011 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature