Τίτλος:
Clinical Experience with Daptomycin for the Treatment of Gram-positive Infections in Children and Adolescents
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: This subgroup analysis of the European Cubicin Outcomes Registry Experience evaluated the safety and effectiveness of daptomycin in children and adolescent patients (<18 years). Methods: Clinical outcomes at the end of therapy were assessed as success (cured or improved), failure or nonevaluable. Safety was assessed for up to 30 days post treatment. Results: Eighty-one children and adolescent patients were included in this study. The most common primary infections were bacteremia (19.8%), complicated skin and soft-tissue infection (18.5%), osteomyelitis (13.6%), endocarditis (12.3%), foreign body/prosthetic infection (12.3%), uncomplicated skin and soft-tissue infection (9.9%) and other (13.6%). Daptomycin doses ranged from 4 to >10 mg/kg/day. Median duration of therapy was 12.5 (interquartile range, 7-25; mean, 16.7; standard deviation, 12.8) days. Staphylococcus aureus (46.7%) was the most commonly isolated pathogen (23.8% methicillin-resistant S. aureus). Forty-nine (60.5%) patients completed daptomycin therapy without further antibiotics, 27 (33.3%) switched to another antibiotic, 4 (4.9%) discontinued because of adverse events (AEs) and 1 (1.2%) discontinued because of other reason. Overall, 75 (92.6%; 95% confidence interval: 95.2-100.0%) patients achieved clinical success; 39 of 41 (95.1%) patients receiving daptomycin monotherapy and 36 of 40 (90.0%) patients receiving concomitant antibiotics. Six (7.4%) patients reported AEs, including 1 patient with increased blood creatine phosphokinase. Three (3.7%) patients had serious AEs; 1 (1.2%) had a serious AE possibly related to daptomycin. Conclusion: Daptomycin, alone or combined with other antibiotics and/or surgery, demonstrated high clinical success rates against a wide variety of infections and was well tolerated in children and adolescents. © Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved.
Συγγραφείς:
Syriopoulou, V.
Dailiana, Z.
Dmitriy, N.
Utili, R.
Pathan, R.
Hamed, K.
Περιοδικό:
The Pediatric Infectious Disease Journal
Εκδότης:
Lippincott Williams and Wilkins
Λέξεις-κλειδιά:
creatine kinase; daptomycin; antiinfective agent; daptomycin, acute kidney failure; adolescent; anaphylaxis; antibiotic therapy; Article; bacteremia; bacterial arthritis; bacterial endocarditis; bacterium isolation; child; coagulase negative Staphylococcus; controlled study; creatine kinase blood level; debridement; device removal; drug efficacy; drug safety; drug substitution; drug withdrawal; dyspnea; Enterococcus faecium; female; follow up; Gram positive infection; heart valve replacement; human; hypersensitivity; incision; lung hemorrhage; major clinical study; male; methicillin resistant Staphylococcus aureus; monotherapy; osteomyelitis; osteosarcoma; outcome assessment; preschool child; priority journal; prosthesis infection; rash; school child; side effect; skin infection; soft tissue infection; Staphylococcus aureus; Staphylococcus epidermidis; surgical drainage; tachycardia; treatment duration; urinary tract infection; Drug-Related Side Effects and Adverse Reactions; Gram-Positive Bacterial Infections; infant; newborn; pathology; treatment outcome, Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Daptomycin; Drug-Related Side Effects and Adverse Reactions; Female; Gram-Positive Bacterial Infections; Humans; Infant; Infant, Newborn; Male; Treatment Outcome
DOI:
10.1097/INF.0000000000001076
