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