ABSTRACT
Introducción Se disponen de pocos datos acerca de la seguridad y eficacia de daptomicina en dosis elevadas (> 8mg/kg/día).Material y métodos Estudio ambispectivo de todos los pacientes que recibieron daptomicina (..) (AU)
Introduction: There is a paucity of data regarding efficacy and safety of high dose (> 8 mg/kg/day)daptomycin. Material and methods: This ambispective study included all patients that received (..) (AU)
Subject(s)
Humans , Daptomycin/administration & dosage , Infections/drug therapy , Daptomycin/toxicity , Anti-Bacterial Agents/toxicityABSTRACT
INTRODUCTION: There is a paucity of data regarding efficacy and safety of high dose (>8mg/kg/day) daptomycin. MATERIAL AND METHODS: This ambispective study included all patients that received ≥8 mg/kg/day of daptomycin and had efficacy and safety data. RESULTS: Sixty-nine patients were included. Fifty-nine patients (85.5%) were recorded as having been cured or improved. Six patients (8.6%) had a raised CPK during follow-up with no clinical signs of myopathy in any of them. CONCLUSIONS: High dose daptomycin shows good efficacy without concerns about toxicity.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Daptomycin/administration & dosage , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/adverse effects , Daptomycin/adverse effects , Female , Humans , Male , Middle Aged , Prospective Studies , Retrospective StudiesABSTRACT
Las infecciones graves causadas por bacterias grampositivas son un problema grave y que se asocia a una elevada mortalidad. Entre ellas, hay que resaltar las causadas por Staphylococcus aureus resistente a meticilina siendo la bacteriemia primaria o asociada a catéter o a endocarditis las principales presentaciones. Vancomicina ha sido tradicionalmente el tratamiento de elección para estas infecciones pero su actividad no es satisfactoria especialmente en caso de SARM con concentración mínima inhibitoria (CMI) > 1mg/L. Daptomicina es un antibiótico lipopéptido cuyo espectro de acción son las bacterias grampositivas incluyendo SARM y Enterococcus spp resistente a glucopéptido. Destacar también que frente a S. aureus sensible a meticilina, daptomicina es rápidamente bactericida y más activo que vancomicina y al menos tan activo como las penicilinas isoxazólicas, En el presente artículo se discute el papel de este antibiótico en el tratamiento empírico y dirigido de las infecciones por bacterias grampositivas que afectan a los pacientes críticos(AU)
Infections caused by Gram-positive bacteria are a serious problem and is associated with high mortality. Among them, we should highlight those caused by methicillin-resistant Staphylococcus aureus (MRSA). Primary bacteremia, catheterrelated bloodstream infections and constitute the main presentations. Vancomycin has traditionally been the treatment of choice for these infections, but its activity is not satisfactory especially in cases of MRSA with minimum inhibitory concentration (MIC) > 1 mg/L. Daptomycin is a lipopeptide antibiotic active against Gram-positive bacteria including MRSA and glycopeptide-resistant Enterococcus spp. It is worth mentioning that daptomycin is rapidly bactericidal against methicillin-sensitive S. aureus, more potent than vancomycin and at least as active as isoxazole penicillins. This article discusses the role of this antibiotic in the empirical treatment of infections and directed by Gram-positive bacteria affecting critically ill patients(AU)