Daptomycin is effective in the treatment of skin and soft tissue infections.
Daptomycin is effective against infections of the skin and soft tissues caused by strains of Staphylococcus aureus sensitive to methicillin and resistant to methicillin.
Daptomycin has been shown to be effective in skin and soft tissue infections caused by both methicillin-sensitive (MSSA) and resistant strains, according to a study presented at the 2008 Annual Conference on Antimicrobial Resistance methicillin (MRSA) Staphylococcus aureus - treatment results in the two groups were comparable.
Often, with infections caused by MRSA, there is clinical ineffectiveness of treatment and, in connection with this, the costs associated with hospitalizing patients increase compared to skin and soft tissue infections caused by MSSA. At this time, it is unclear whether this is a direct effect of MRSA as a pathogen, or whether the differences in treatment tactics between treating infections caused by MRSA and MSSA also have a effect on results.
Since daptomycin has the same activity against MSSA and MRSA, the researchers compared the results of treatment with daptomycin in patients with infections caused by methicillin-resistant and methicillin-resistant strains of Staphylococcus aureus.
Identify patients with skin and soft tissue infections in which S. was the primary pathogen. aureus, the Cubicin results and experience register for the period 2005-2006 was used. Of the 486 patients identified, 52 people (11%) were excluded from the analysis due to the impossibility of evaluating the results of the treatment. The results were evaluated at the end of the treatment with daptomycin, the effectiveness of the treatment being defined as a cure or an improvement.
Of the 434 patients to be assessed, 338 people (78%) had MRSA infection and 96 (22%) had MSSA. In addition, in patients with diabetes mellitus, the frequency of MRSA infections was lower (28% vs 41%, p = 0.02); fewer MRSA-infected patients received dialysis at the start of daptomycin therapy (1.5% vs 7.3%; p = 0.008), and MRSA was more frequent released in uncomplicated skin and soft tissue infections (29% vs 18%, p = 0.04). These parameters did not affect the clinical outcome of treatment.
Most patients have shown clinical efficacy of treatment with daptomycin (96% of patients infected with MRSA and 95% of patients infected with MSSA, p = 0.5). In 95 patients (22%), daptomycin was used as a first-line drug. Vancomycin was the most common previous antibacterial drug (46% of patients received it with MRSA infection and 45% with MSSA infection); approximately 1/3 of the patients were switched to daptomycin due to the ineffectiveness of vancomycin.
The doses of daptomycin received by the cohorts of patients compared were comparable (MRSA - 4 mg / kg (56% of patients), from 2.9 to 10 mg / kg; MSSA - also 4 mg / kg (59% of patients) , from 3 to 8 5 mg / kg); the mean duration of treatment did not differ significantly between the groups (MRSA - 13 days, MSSA - 11 days, p = 0.4). The incidence of adverse events, possibly associated with the use of daptomycin, was also comparable between the groups compared (MRSA - 5%, MSSA - 9%).
Thus, in this group of patients, methicillin resistance did not affect the clinical success rate of treatment at the time of treatment with daptomycin.