PMID- 34439067
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210830
IS  - 2079-6382 (Print)
IS  - 2079-6382 (Electronic)
IS  - 2079-6382 (Linking)
VI  - 10
IP  - 8
DP  - 2021 Aug 21
TI  - Daptomycin versus Vancomycin for the Treatment of Methicillin-Resistant 
      Staphylococcus aureus Bloodstream Infection with or without Endocarditis: A 
      Systematic Review and Meta-Analysis.
LID - 10.3390/antibiotics10081014 [doi]
LID - 1014
AB  - BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is an important 
      cause of invasive infections, mainly bloodstream infections (BSI) with or without 
      endocarditis. The purpose of this meta-analysis was to compare vancomycin, the 
      mainstay treatment, with daptomycin as therapeutic options in this context. 
      MATERIALS: PubMed, Embase and the Cochrane Database were searched from their 
      inception to 15 February 2020. The primary outcome was all-cause mortality. 
      Secondary outcomes included clinical failure, infection recurrence, persistence 
      of infection, length-of-stay, antibiotic discontinuation due to adverse events 
      (AEs) and 30-day re-admission. This study was registered with PROSPERO, 
      CRD42020169413. RESULTS: Eight studies (1226 patients, 554 vs. 672 in daptomycin 
      vs. vancomycin, respectively) were included. No significant difference in terms 
      of overall mortality was observed [odds ratio (OR) 0.73, 95% confidence interval 
      (CI) 0.40-1.33, I(2) = 67%]. Daptomycin was associated with a significantly 
      reduced risk of clinical failure (OR 0.58, 95% CI 0.38-0.89, I(2) = 60%), as 
      confirmed by pooling adjusted effect sizes (adjusted OR against the use of 
      vancomycin 1.94, 95%CI 1.33-1.82, I(2) = 41%), and was linked with fewer 
      treatment-limiting AEs (OR 0.15, 95%CI 0.06-0.36, I(2) = 19%). No difference 
      emerged between the two treatments as secondary outcomes. Results were not robust 
      to unmeasured confounding (E-value lower than 95% CI 1.00 for all-cause 
      mortality). CONCLUSIONS: Against MRSA BSI, with or without endocarditis, 
      daptomycin seems to be associated with a lower risk of clinical failure and 
      treatment-limiting AEs compared with vancomycin. Further studies are needed to 
      better characterize the differences between the two drugs.
FAU - Maraolo, Alberto Enrico
AU  - Maraolo AE
AUID- ORCID: 0000-0002-7218-7762
AD  - First Division of Infectious Diseases, Cotugno Hospital, AORN Dei Colli, 80131 
      Naples, Italy.
FAU - Giaccone, Agnese
AU  - Giaccone A
AUID- ORCID: 0000-0003-4002-0930
AD  - Section of Infectious Diseases, Department of Clinical Medicine and Surgery, 
      University of Naples Federico II, 80131 Naples, Italy.
FAU - Gentile, Ivan
AU  - Gentile I
AUID- ORCID: 0000-0002-5199-8451
AD  - Section of Infectious Diseases, Department of Clinical Medicine and Surgery, 
      University of Naples Federico II, 80131 Naples, Italy.
FAU - Saracino, Annalisa
AU  - Saracino A
AD  - Department of Biomedical Sciences and Human Oncology, Clinic of Infectious 
      Diseases, University of Bari, 70121 Bari, Italy.
FAU - Bavaro, Davide Fiore
AU  - Bavaro DF
AUID- ORCID: 0000-0002-4833-7118
AD  - Department of Biomedical Sciences and Human Oncology, Clinic of Infectious 
      Diseases, University of Bari, 70121 Bari, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20210821
PL  - Switzerland
TA  - Antibiotics (Basel)
JT  - Antibiotics (Basel, Switzerland)
JID - 101637404
PMC - PMC8389004
OTO - NOTNLM
OT  - MRSA
OT  - Staphylococcus aureus
OT  - bloodstream infection
OT  - daptomycin
OT  - endocarditis
OT  - vancomycin
COIS- The authors declare no conflict of interest.
EDAT- 2021/08/28 06:00
MHDA- 2021/08/28 06:01
PMCR- 2021/08/21
CRDT- 2021/08/27 01:02
PHST- 2021/07/14 00:00 [received]
PHST- 2021/08/05 00:00 [revised]
PHST- 2021/08/19 00:00 [accepted]
PHST- 2021/08/27 01:02 [entrez]
PHST- 2021/08/28 06:00 [pubmed]
PHST- 2021/08/28 06:01 [medline]
PHST- 2021/08/21 00:00 [pmc-release]
AID - antibiotics10081014 [pii]
AID - antibiotics-10-01014 [pii]
AID - 10.3390/antibiotics10081014 [doi]
PST - epublish
SO  - Antibiotics (Basel). 2021 Aug 21;10(8):1014. doi: 10.3390/antibiotics10081014.