Clinical Experience with Daptomycin in Pediatrics

Katie C. Namtu, Julianna C. Crain, Allison F. Messina, Juan A. Dumois, David M. Berman

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: The management of gram-positive infections has been complicated in recent years by the emergence of antimicrobial resistance, leaving fewer options for therapy. Daptomycin is a lipopeptide antibiotic used for the systemic treatment of gram-positive infections. It has a distinct mechanism of action and a favorable side effect profile, and it requires once/day dosing. Unfortunately, there is a paucity of safety, efficacy, and pharmacokinetic data in neonatal and pediatric patients. The objective of this study was to review our experience with daptomycin use for the treatment of gram-positive infections in these patient populations. Methods: We conducted a retrospective analysis of electronic medical records of hospitalized children who received daptomycin between October 2008 and June 2014 for the treatment of proven gram-positive infections. Results: Of the 146 patients who received at least 3 days of daptomycin therapy, 109 patients had a proven gram-positive infection and were included for further analysis. Of the 109 patients, 71 were males (65%) and the median age was 12 years (range: 2.5 mo to 24 yrs). The median duration of therapy was 12 days (range: 3–121 days; mean = 16 days). Catheter-related bloodstream infections were the most common type of infections (n=81 patients) in those receiving daptomycin treatment. One hundred seven patients (98%) had documented improvement and resolution at the time of hospital discharge. One hundred four patients (95%) had a baseline creatine phosphokinase (CPK) level obtained. Of these 104 patients, 48 (46%) had at least one follow-up CPK level after the start of therapy. Three patients’ charts showed laboratory evidence of elevated CPK values. Conclusions: The majority of patients demonstrated clinical improvement after receiving daptomycin as primary therapy for proven gram-positive infections. Larger randomized controlled trials focusing on safety and efficacy are necessary to assess these outcomes with daptomycin use in the pediatric population.

Original languageEnglish (US)
Pages (from-to)105-108
Number of pages4
JournalPharmacotherapy
Volume37
Issue number1
DOIs
StatePublished - Jan 1 2017
Externally publishedYes

Keywords

  • antibiotics
  • antimicrobials
  • daptomycin
  • gram-positive infections
  • pediatrics

ASJC Scopus subject areas

  • Pharmacology (medical)

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