Association of daptomycin dosing regimen and mortality in patients with VRE bacteraemia: A review

Farnaz Foolad, Brandie D. Taylor, Samuel A. Shelburne, Cesar A. Arias, Samuel L. Aitken

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

VRE are associated with ∼1300 deaths per year in the USA. Recent literature suggests that daptomycin, a cyclic lipopeptide antibiotic with concentration-dependent bactericidal activity, is the preferred treatment option for VRE bacteraemia, yet the optimal dosing strategy for this indication has not been established. In vitro evidence suggests that higher-than-labelled doses of daptomycin are required to optimally treat VRE bacteraemia and to inhibit the development of resistance. However, concern of dose-dependent toxicities, notably increases in creatine phosphokinase and the development of rhabdomyolysis, are a barrier to initiating high-dose schemes in clinical practice. Thus, the effectiveness and safety of high-dose daptomycin regimens in clinical practice have remained unclear. While early studies failed to identify differences in mortality, newer, larger investigations suggest high-dose (≥9mg/kg) daptomycin is associated with reduced mortality in patients with VRE bacteraemia compared with standard (6mg/kg) dosing regimens. Additionally, the high-dose regimens appear to be safe and may be associated with improved microbiological outcomes. The purpose of this review is to examine the published evidence on the effectiveness and safety of high-dose daptomycin compared with standard dosing regimens for VRE bacteraemia.

Original languageEnglish (US)
Pages (from-to)2277-2283
Number of pages7
JournalJournal of Antimicrobial Chemotherapy
Volume73
Issue number9
DOIs
StatePublished - Jan 1 2018

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Daptomycin
Bacteremia
Mortality
Lipopeptides
Safety
Rhabdomyolysis
Creatine Kinase
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Pharmacology
  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Association of daptomycin dosing regimen and mortality in patients with VRE bacteraemia : A review. / Foolad, Farnaz; Taylor, Brandie D.; Shelburne, Samuel A.; Arias, Cesar A.; Aitken, Samuel L.

In: Journal of Antimicrobial Chemotherapy, Vol. 73, No. 9, 01.01.2018, p. 2277-2283.

Research output: Contribution to journalReview article

Foolad, Farnaz ; Taylor, Brandie D. ; Shelburne, Samuel A. ; Arias, Cesar A. ; Aitken, Samuel L. / Association of daptomycin dosing regimen and mortality in patients with VRE bacteraemia : A review. In: Journal of Antimicrobial Chemotherapy. 2018 ; Vol. 73, No. 9. pp. 2277-2283.
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