Articles producció científica> Ciències Mèdiques Bàsiques

Daptomycin Plus Fosfomycin Versus Daptomycin Alone for Methicillin-resistant Staphylococcus aureus Bacteremia and Endocarditis: A Randomized Clinical Trial

  • Identification data

    Identifier: imarina:9220612
    Authors:
    Haddadin, ZaidBatarseh, EinasHamdan, LubnaStewart, Laura S.Piya, BhinnataRahman, HerdiSpieker, Andrew J.Chappell, JamesWikswo, Mary E.Dunn, John R.Payne, Daniel C.Vinje, JanHall, Aron J.Halasa, Natasha
    Abstract:
    Background. We aimed to determine whether daptomycin plus fosfomycin provides higher treatment success than daptomycin alone for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and endocarditis.Methods. A randomized (1:1) phase 3 superiority, open-label, and parallel group clinical trial of adult inpatients with MRSA bacteremia was conducted at 18 Spanish hospitals. Patients were randomly assigned to receive either 10 mg/kg of daptomycin intravenously daily plus 2 g of fosfomycin intravenously every 6 hours, or 10 mg/kg of daptomycin intravenously daily. Primary endpoint was treatment success 6 weeks after the end of therapy.Results. Of 167 patients randomized, 155 completed the trial and were assessed for the primary endpoint. Treatment success at 6 weeks after the end of therapy was achieved in 40 of 74 patients who received daptomycin plus fosfomycin and in 34 of 81 patients who were given daptomycin alone (54.1% vs 42.0%; relative risk, 1.29 [95% confidence interval, .93-1.8]; P = .135). At 6 weeks, daptomycin plus fosfomycin was associated with lower microbiologic failure (0 vs 9 patients; P = .003) and lower complicated bacteremia (16.2% vs 32.1%; P = .022). Adverse events leading to treatment discontinuation occurred in 13 of 74 patients (17.6%) receiving daptomycin plus fosfomycin, and in 4 of 81 patients (4.9%) receiving daptomycin alone (P = .018).Conclusions. Daptomycin plus fosfomycin provided 12% higher rate of treatment success than daptomycin alone, but this difference did not reach statistical significance. This antibiotic combination prevented microbiological failure and complicated bacteremia, but it was more often associated with adverse events.
  • Others:

    Author, as appears in the article.: Haddadin, Zaid; Batarseh, Einas; Hamdan, Lubna; Stewart, Laura S.; Piya, Bhinnata; Rahman, Herdi; Spieker, Andrew J.; Chappell, James; Wikswo, Mary E.; Dunn, John R.; Payne, Daniel C.; Vinje, Jan; Hall, Aron J.; Halasa, Natasha;
    Department: Ciències Mèdiques Bàsiques
    URV's Author/s: Garcia Pardo, Graciano / TEBÉ CORDOMÍ, CRISTIAN
    Keywords: Vancomycin Treatment outcome Therapy Staphylococcus infection Staphylococcal infections Randomized controlled trial Multicenter Mrsa Mortality Methicillin-resistant staphylococcus aureus Methicillin resistant staphylococcus aureus Humans Human Fosfomycin Endocarditis Daptomycin Criteria Controlled study Clinical trial Beta-lactam Bacteremia Antiinfective agent Anti-bacterial agents Adult vancomycin therapy multicenter mortality fosfomycin daptomycin criteria clinical trial bacteremia
    Abstract: Background. We aimed to determine whether daptomycin plus fosfomycin provides higher treatment success than daptomycin alone for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and endocarditis.Methods. A randomized (1:1) phase 3 superiority, open-label, and parallel group clinical trial of adult inpatients with MRSA bacteremia was conducted at 18 Spanish hospitals. Patients were randomly assigned to receive either 10 mg/kg of daptomycin intravenously daily plus 2 g of fosfomycin intravenously every 6 hours, or 10 mg/kg of daptomycin intravenously daily. Primary endpoint was treatment success 6 weeks after the end of therapy.Results. Of 167 patients randomized, 155 completed the trial and were assessed for the primary endpoint. Treatment success at 6 weeks after the end of therapy was achieved in 40 of 74 patients who received daptomycin plus fosfomycin and in 34 of 81 patients who were given daptomycin alone (54.1% vs 42.0%; relative risk, 1.29 [95% confidence interval, .93-1.8]; P = .135). At 6 weeks, daptomycin plus fosfomycin was associated with lower microbiologic failure (0 vs 9 patients; P = .003) and lower complicated bacteremia (16.2% vs 32.1%; P = .022). Adverse events leading to treatment discontinuation occurred in 13 of 74 patients (17.6%) receiving daptomycin plus fosfomycin, and in 4 of 81 patients (4.9%) receiving daptomycin alone (P = .018).Conclusions. Daptomycin plus fosfomycin provided 12% higher rate of treatment success than daptomycin alone, but this difference did not reach statistical significance. This antibiotic combination prevented microbiological failure and complicated bacteremia, but it was more often associated with adverse events.
    Thematic Areas: Saúde coletiva Odontología Microbiology (medical) Microbiology Medicina veterinaria Medicina iii Medicina ii Medicina i Interdisciplinar Infectious diseases Immunology General medicine Farmacia Engenharias ii Engenharias i Enfermagem Ciências biológicas iii Ciências biológicas ii Ciências biológicas i Biotecnología Biodiversidade
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: graciano.garcia@urv.cat
    Record's date: 2024-09-07
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://academic.oup.com/cid/article/72/9/1517/5877897?login=false
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Clinical Infectious Diseases. 72 (9): 1517-1525
    APA: Haddadin, Zaid; Batarseh, Einas; Hamdan, Lubna; Stewart, Laura S.; Piya, Bhinnata; Rahman, Herdi; Spieker, Andrew J.; Chappell, James; Wikswo, Mary E. (2021). Daptomycin Plus Fosfomycin Versus Daptomycin Alone for Methicillin-resistant Staphylococcus aureus Bacteremia and Endocarditis: A Randomized Clinical Trial. Clinical Infectious Diseases, 72(9), 1517-1525. DOI: 10.1093/cid/ciaa1081
    Article's DOI: 10.1093/cid/ciaa1081
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2021
    Publication Type: Journal Publications
  • Keywords:

    Immunology,Infectious Diseases,Microbiology,Microbiology (Medical)
    Vancomycin
    Treatment outcome
    Therapy
    Staphylococcus infection
    Staphylococcal infections
    Randomized controlled trial
    Multicenter
    Mrsa
    Mortality
    Methicillin-resistant staphylococcus aureus
    Methicillin resistant staphylococcus aureus
    Humans
    Human
    Fosfomycin
    Endocarditis
    Daptomycin
    Criteria
    Controlled study
    Clinical trial
    Beta-lactam
    Bacteremia
    Antiinfective agent
    Anti-bacterial agents
    Adult
    vancomycin
    therapy
    multicenter
    mortality
    fosfomycin
    daptomycin
    criteria
    clinical trial
    bacteremia
    Saúde coletiva
    Odontología
    Microbiology (medical)
    Microbiology
    Medicina veterinaria
    Medicina iii
    Medicina ii
    Medicina i
    Interdisciplinar
    Infectious diseases
    Immunology
    General medicine
    Farmacia
    Engenharias ii
    Engenharias i
    Enfermagem
    Ciências biológicas iii
    Ciências biológicas ii
    Ciências biológicas i
    Biotecnología
    Biodiversidade
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