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Short-course daptomycin lock and systemic therapy for catheter-related bloodstream infections: a retrospective cohort study in cancer patients with surgically implanted devices.
Vassallo, Matteo; Genillier, Pierre-Luc; Dunais, Brigitte; Kaphan, Regis; Saudes, Laurence; Duval, Yannick; Rolland, Fabien; Jullien, Valerie; Weiss, Nicolas; Blanchouin, Elea; Boscagli, Annick; Perrin, Christophe; Montagne, Nathalie.
Afiliación
  • Vassallo M; a Department of Internal Medicine/Infectious Diseases , Cannes General Hospital , France.
  • Genillier PL; b Department of Medical Informatics , Cannes General Hospital , France.
  • Dunais B; c Department of Public Health , Nice University Hospital , France.
  • Kaphan R; a Department of Internal Medicine/Infectious Diseases , Cannes General Hospital , France.
  • Saudes L; a Department of Internal Medicine/Infectious Diseases , Cannes General Hospital , France.
  • Duval Y; d Department of Pneumology , Cannes General Hospital , France.
  • Rolland F; d Department of Pneumology , Cannes General Hospital , France.
  • Jullien V; d Department of Pneumology , Cannes General Hospital , France.
  • Weiss N; a Department of Internal Medicine/Infectious Diseases , Cannes General Hospital , France.
  • Blanchouin E; a Department of Internal Medicine/Infectious Diseases , Cannes General Hospital , France.
  • Boscagli A; a Department of Internal Medicine/Infectious Diseases , Cannes General Hospital , France.
  • Perrin C; d Department of Pneumology , Cannes General Hospital , France.
  • Montagne N; a Department of Internal Medicine/Infectious Diseases , Cannes General Hospital , France.
J Chemother ; 29(4): 232-237, 2017 Aug.
Article en En | MEDLINE | ID: mdl-28120698
ABSTRACT

PURPOSE:

Few in vivo studies have been reported describing efficacy and duration of antibiotic lock therapy (ALT) with daptomycin (DPT) for long-term catheter-related bloodstream infections (CRBSI) due to coagulase-negative staphylococci (CoNS). We retrospectively analysed the efficacy of short-course ALT with DPT in combination with systemic treatment (ST) for CoNS-associated CRBSI in our hospital.

METHODS:

Patients admitted for CoNS-associated CRBSI and treated with DPT as ALT and ST were retrospectively analysed. Success was defined as preservation of the catheter device 30 days after ending treatment. Catheter removal within 30 days of discontinuing treatment, for either microbiological documentation of CRBSI relapse or re-occurrence of unexplained fever, was considered as failure.

RESULTS:

Among 7610 patients admitted to the Departments of Internal Medicine/Infectious Diseases and Pneumology in Cannes from January 2013 to November 2015, we identified 28 episodes of CoNS-associated CRBSI. Seven patients died of cancer during follow-up. Thus, 21 episodes were analysed among 20 patients (median age 67 years, 12 males, all treated for neoplasia and carrying a port-a-cath® device). Staphylococcus epidermidis was the main agent responsible for CRBSI. Median duration of systemic and ALT DPT was 3 days, in combination with rifampin for 4 days and then generally followed by a switch to oral drugs, most frequently cotrimoxazole or linezolid, to achieve 14 median days of treatment. Clinical success and failure rates were 76% and 24%, respectively.

CONCLUSIONS:

Short-course DPT as ALT, combined with 14 days of ST, allowed conservative management of CoNS-associated CRBSI in surgically implanted-catheters in three-fourth of cases.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Catéteres de Permanencia / Bacteriemia / Daptomicina / Infecciones Relacionadas con Catéteres / Neoplasias Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Chemother Asunto de la revista: ANTINEOPLASICOS / TERAPIA POR MEDICAMENTOS Año: 2017 Tipo del documento: Article País de afiliación: Francia

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Catéteres de Permanencia / Bacteriemia / Daptomicina / Infecciones Relacionadas con Catéteres / Neoplasias Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Chemother Asunto de la revista: ANTINEOPLASICOS / TERAPIA POR MEDICAMENTOS Año: 2017 Tipo del documento: Article País de afiliación: Francia
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