Vancomycin-resistant enterococcal bacteraemia: Is daptomycin as effective as linezolid?

Vidya Mave, Julia Garcia-Diaz, Tareq Islam, Rodrigo Hasbun

Research output: Contribution to journalArticle

Abstract

Background: The treatment of vancomycin-resistant enterococcal (VRE) bacteraemia remains challenging. Daptomycin is a new antibiotic with bactericidal activity against VRE, but available clinical data are limited. Methods: A retrospective study was performed on 98 adult patients with VRE bacteraemia admitted to two hospitals between September 2003 and December 2007 to compare the efficacy of daptomycin with that of linezolid. Multivariable analyses were performed to compare the microbiological and clinical outcomes of both groups. Results: Out of 98 patients with VRE bacteraemia, 68 were treated with linezolid and 30 with daptomycin. Univariate analyses showed no significant differences between the groups regarding baseline demographic and clinical characteristics, severity of illness and co-morbidity. Daptomycin was associated with a trend towards a higher mortality rate (26.7% versus 20.6%), longer median duration of bacteraemia (3 days versus 2 days) and higher relapse rate (6.7% versus 2.9%), but these differences did not reach statistical significance (P > 0.2). Microbiological cure rates were 90% for the daptomycin group and 88.2% for the linezolid group (P = 0.92). Conclusions: Despite a trend towards worse outcomes, daptomycin was as effective as linezolid in treating VRE bacteraemia. A randomized clinical trial is needed to confirm these results.

Original languageEnglish (US)
Pages (from-to)175-180
Number of pages6
JournalJournal of Antimicrobial Chemotherapy
Volume64
Issue number1
DOIs
Publication statusPublished - 2009
Externally publishedYes

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Keywords

  • Antibiotic resistance
  • Microbiological outcomes
  • Multivariable analyses
  • Sepsis

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

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