PMID- 19628091
OWN - NLM
STAT- MEDLINE
DCOM- 20090818
LR  - 20131121
IS  - 1532-7361 (Electronic)
IS  - 0039-6060 (Linking)
VI  - 146
IP  - 2
DP  - 2009 Aug
TI  - Daptomycin for the treatment of surgical site infections.
PG  - 316-24
LID - 10.1016/j.surg.2009.03.037 [doi]
AB  - BACKGROUND: The increasing frequency of methicillin-resistant Staphylococcus 
      aureus (MRSA) as a cause of surgical site infections, and decreased 
      susceptibility to vancomycin, highlight the need for alternative therapies. 
      METHODS: All patients with a surgical site infection enrolled in the Cubicin 
      Outcomes Registry and Experience (CORE 2007 retrospective multicenter registry 
      were studied. Outcome was assessed at the end of daptomycin therapy using 
      protocol-defined criteria. Success was defined as cured or improved. 
      Non-evaluable patients were excluded from the efficacy analysis but were included 
      in the safety analysis. RESULTS: Of 962 patients in the CORE registry in 2007, 
      104 (11%) had a surgical infection and met the criteria for the efficacy 
      analysis. The overall success rate was 91% (95/104). The distribution of surgical 
      site infections by depth was 36% (38/104) superficial incisional, 36% (38/104) 
      deep incisional, and 27% (28/104) organ/space. Success rates by infection depth 
      were 92% for superficial incisional, 92% deep incisional, and 89% organ/space (P 
      = .9). Success in patients with and without surgery was 89% (49/55) and 94% 
      (46/49) (P = .5). The median final daptomycin dose was 5.5 mg/kg. The median 
      duration of daptomycin therapy was 14 days. Prior antibiotic therapy was given to 
      79% of patients; 35% failed. Prior vancomycin was used in 45% of patients; 24% 
      failed. Among vancomycin failures, the daptomycin success rate was 91% (10/11). 
      Of those with a positive culture, common pathogens were S. aureus (68%; MRSA 61%) 
      and enterococci (26%; vancomycin-resistant 36%). There were 9 possible 
      treatment-related adverse events (AEs) in 8 of 118 (7%) patients; 2 serious AEs 
      were reported in 1 patient. CONCLUSION: Success rates for patients with a 
      surgical site infection treated with daptomycin were high and did not differ 
      based on the need for surgical intervention. High success rates were achieved in 
      patients with infection caused by MRSA as well as in patients who had failed to 
      respond to previous antibiotic therapies, including vancomycin, regardless of the 
      depth of the infection.
FAU - Chamberlain, Ronald S
AU  - Chamberlain RS
AD  - Department of Surgery, St Barnabas Medical Center, Livingston, NJ 07039, USA. 
      rchamberlain@sbhcs.com
FAU - Culshaw, Darren L
AU  - Culshaw DL
FAU - Donovan, Brian J
AU  - Donovan BJ
FAU - Lamp, Kenneth C
AU  - Lamp KC
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Surgery
JT  - Surgery
JID - 0417347
RN  - 0 (Anti-Bacterial Agents)
RN  - NWQ5N31VKK (Daptomycin)
SB  - IM
MH  - Aged
MH  - Anti-Bacterial Agents/adverse effects/*therapeutic use
MH  - Daptomycin/adverse effects/*therapeutic use
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Surgical Wound Infection/*drug therapy/microbiology/pathology
EDAT- 2009/07/25 09:00
MHDA- 2009/08/19 09:00
CRDT- 2009/07/25 09:00
PHST- 2009/01/09 00:00 [received]
PHST- 2009/03/20 00:00 [accepted]
PHST- 2009/07/25 09:00 [entrez]
PHST- 2009/07/25 09:00 [pubmed]
PHST- 2009/08/19 09:00 [medline]
AID - S0039-6060(09)00271-2 [pii]
AID - 10.1016/j.surg.2009.03.037 [doi]
PST - ppublish
SO  - Surgery. 2009 Aug;146(2):316-24. doi: 10.1016/j.surg.2009.03.037.