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Daptomycin Therapy for Osteomyelitis: A Retrospective Study
BACKGROUND: Daptomycin is a rapidly bactericidal agent with broad coverage against Gram-positive organisms, including Staphylococcus aureus, the most frequent cause of osteomyelitis. The objective of this study was to describe the clinical outcome of patients with non-hardware associated osteomyelit...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3521200/ https://www.ncbi.nlm.nih.gov/pubmed/22691420 http://dx.doi.org/10.1186/1471-2334-12-133 |
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author | Gallagher, Jason C Huntington, Jennifer A Culshaw, Darren McConnell, Scott A Yoon, Minjung Berbari, Elie |
author_facet | Gallagher, Jason C Huntington, Jennifer A Culshaw, Darren McConnell, Scott A Yoon, Minjung Berbari, Elie |
author_sort | Gallagher, Jason C |
collection | PubMed |
description | BACKGROUND: Daptomycin is a rapidly bactericidal agent with broad coverage against Gram-positive organisms, including Staphylococcus aureus, the most frequent cause of osteomyelitis. The objective of this study was to describe the clinical outcome of patients with non-hardware associated osteomyelitis, and the safety profile of daptomycin in the treatment of these infections. METHODS: All patients with osteomyelitis, excluding concurrent orthopedic foreign body infections, treated with daptomycin and identified between 2007–2008 in a retrospective, multicenter, observational registry, were included. Investigators assessed patient outcome (cured, improved, failed, non-evaluable) at the end of daptomycin therapy. Patients with a successful outcome at the end of daptomycin therapy were reassessed in 2009. All patients were included in the safety analysis; evaluable patients were included in the efficacy analysis. Data was assessed using descriptive statistics. A Kaplan Meier analysis was used to assess time to clinical failure. RESULTS: Two-hundred and nine osteomyelitis patients successfully completed daptomycin therapy in 2007–2008, 71 of which (34%) had a follow-up visit in 2009 and had an evaluable clinical outcome. The median (min, max) daptomycin dose and duration were 6 mg/kg (4, 10) and 42 days (1, 88), respectively. Of the 52 patients with a documented pathogen, S. aureus was the most common (42%); primarily methicillin-resistant S. aureus. All patients were included in the safety analysis; evaluable patients were included in the efficacy analysis. Clinical resolution was reported in 94% (CI - 86.2%, 98.44%) of patients. A Kaplan Meier analysis of time to clinical failure showed that approximately 85% (CI – 64%, 95%) of patients had a continued successful outcome at the time of re-evaluation. Eighteen patients (25%) in the safety population experienced an adverse event; 13 patients (18%) had an adverse event that was possibly-related to daptomycin treatment. CONCLUSIONS: Daptomycin appears to be an effective therapeutic choice with an acceptable safety profile in the management of osteomyelitis that does not involve hardware. |
format | Online Article Text |
id | pubmed-3521200 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-35212002012-12-14 Daptomycin Therapy for Osteomyelitis: A Retrospective Study Gallagher, Jason C Huntington, Jennifer A Culshaw, Darren McConnell, Scott A Yoon, Minjung Berbari, Elie BMC Infect Dis Research Article BACKGROUND: Daptomycin is a rapidly bactericidal agent with broad coverage against Gram-positive organisms, including Staphylococcus aureus, the most frequent cause of osteomyelitis. The objective of this study was to describe the clinical outcome of patients with non-hardware associated osteomyelitis, and the safety profile of daptomycin in the treatment of these infections. METHODS: All patients with osteomyelitis, excluding concurrent orthopedic foreign body infections, treated with daptomycin and identified between 2007–2008 in a retrospective, multicenter, observational registry, were included. Investigators assessed patient outcome (cured, improved, failed, non-evaluable) at the end of daptomycin therapy. Patients with a successful outcome at the end of daptomycin therapy were reassessed in 2009. All patients were included in the safety analysis; evaluable patients were included in the efficacy analysis. Data was assessed using descriptive statistics. A Kaplan Meier analysis was used to assess time to clinical failure. RESULTS: Two-hundred and nine osteomyelitis patients successfully completed daptomycin therapy in 2007–2008, 71 of which (34%) had a follow-up visit in 2009 and had an evaluable clinical outcome. The median (min, max) daptomycin dose and duration were 6 mg/kg (4, 10) and 42 days (1, 88), respectively. Of the 52 patients with a documented pathogen, S. aureus was the most common (42%); primarily methicillin-resistant S. aureus. All patients were included in the safety analysis; evaluable patients were included in the efficacy analysis. Clinical resolution was reported in 94% (CI - 86.2%, 98.44%) of patients. A Kaplan Meier analysis of time to clinical failure showed that approximately 85% (CI – 64%, 95%) of patients had a continued successful outcome at the time of re-evaluation. Eighteen patients (25%) in the safety population experienced an adverse event; 13 patients (18%) had an adverse event that was possibly-related to daptomycin treatment. CONCLUSIONS: Daptomycin appears to be an effective therapeutic choice with an acceptable safety profile in the management of osteomyelitis that does not involve hardware. BioMed Central 2012-06-12 /pmc/articles/PMC3521200/ /pubmed/22691420 http://dx.doi.org/10.1186/1471-2334-12-133 Text en Copyright ©2012 Gallagher et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Gallagher, Jason C Huntington, Jennifer A Culshaw, Darren McConnell, Scott A Yoon, Minjung Berbari, Elie Daptomycin Therapy for Osteomyelitis: A Retrospective Study |
title | Daptomycin Therapy for Osteomyelitis: A Retrospective Study |
title_full | Daptomycin Therapy for Osteomyelitis: A Retrospective Study |
title_fullStr | Daptomycin Therapy for Osteomyelitis: A Retrospective Study |
title_full_unstemmed | Daptomycin Therapy for Osteomyelitis: A Retrospective Study |
title_short | Daptomycin Therapy for Osteomyelitis: A Retrospective Study |
title_sort | daptomycin therapy for osteomyelitis: a retrospective study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3521200/ https://www.ncbi.nlm.nih.gov/pubmed/22691420 http://dx.doi.org/10.1186/1471-2334-12-133 |
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