Articles producció científica> Ciències Mèdiques Bàsiques

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

  • Datos identificativos

    Identificador: imarina:9220612
    Autores:
    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
    Resumen:
    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.
  • Otros:

    Autor según el artículo: 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;
    Departamento: Ciències Mèdiques Bàsiques
    Autor/es de la URV: Garcia Pardo, Graciano / TEBÉ CORDOMÍ, CRISTIAN
    Palabras clave: 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
    Resumen: 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.
    Áreas temáticas: 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
    Acceso a la licencia de uso: https://creativecommons.org/licenses/by/3.0/es/
    Direcció de correo del autor: graciano.garcia@urv.cat
    Fecha de alta del registro: 2024-09-07
    Versión del articulo depositado: info:eu-repo/semantics/publishedVersion
    Enlace a la fuente original: https://academic.oup.com/cid/article/72/9/1517/5877897?login=false
    URL Documento de licencia: https://repositori.urv.cat/ca/proteccio-de-dades/
    Referencia al articulo segun fuente origial: Clinical Infectious Diseases. 72 (9): 1517-1525
    Referencia de l'ítem segons les normes 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
    DOI del artículo: 10.1093/cid/ciaa1081
    Entidad: Universitat Rovira i Virgili
    Año de publicación de la revista: 2021
    Tipo de publicación: Journal Publications
  • Palabras clave:

    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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