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Daptomycin Therapy for Osteomyelitis: A Retrospective Study Full Text
BMC Infectious Diseases, 06/20/2012
Clinical Article
Gallagher JC et al. – Daptomycin appears to be an effective therapeutic choice with an acceptable safety profile in the management of osteomyelitis that does not involve hardware.
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.
- 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.
