Tolerability of High Doses of Daptomycin in the Treatment of Prosthetic Vascular Graft Infection : A Retrospective Study
INTRODUCTION: In treatment of prosthetic vascular graft infection (PVGI), appropriate antimicrobial treatment is crucial for controlling the septic process and preventing re-infection of the new graft. Glycopeptides are the mainstay of treatment for device-related infections by methicillin-resistant Staphylococcus aureus strains, but with some limitations, especially concerning vancomycin-intermediate and glycopeptide-intermediate S. aureus. We report our experience using a high dose of daptomycin (DAP) for treatment of PVGI.
METHODS: We reviewed medical reports of 26 patients treated with high doses of DAP (>8 mg/kg) and beta-lactams/aminosides for PVGI, defined as positive bacterial culture of intraoperative specimens or blood samples and/or clinical, biological, and radiological signs of infection. Clinical success was defined by resolution of all clinical signs at the end of follow-up, without the need for additional antibiotic therapy, and/or negative culture in case of new surgery.
RESULTS: Cultures of intraoperative samples were positive in 21 patients (80.8%). Blood and intraoperative cultures were concomitantly positive in 10 patients. The main microorganism identified in microbiological samples was S. aureus (n = 18). Surgery was performed in 23 patients (88.4%). The mean duration of the DAP regimen was 12.3 ± 11.9 days. DAP was discontinued in 26 patients [need to switch to microbiological results (n = 19), bacterial pneumonia (n = 2), and increased creatine phosphokinase levels (n = 4)]. One patient had myalgia, while 9 received concomitant statins.
CONCLUSION: High-dose DAP therapy shows a satisfactory toxicity profile even in severely ill patients with multiple comorbidities, and may favorably compete with vancomycin, especially concerning the risk of induced nephrotoxicity.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2014 |
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| Erschienen: |
2014 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:3 |
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| Enthalten in: |
Infectious diseases and therapy - 3(2014), 2 vom: 08. Dez., Seite 215-23 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Legout, Laurence [VerfasserIn] |
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| Links: |
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| Themen: |
Biofilm |
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| Anmerkungen: |
Date Completed 04.04.2016 Date Revised 30.03.2024 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1007/s40121-014-0035-9 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM241569443 |
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| 100 | 1 | |a Legout, Laurence |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Tolerability of High Doses of Daptomycin in the Treatment of Prosthetic Vascular Graft Infection |b A Retrospective Study |
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| 500 | |a Date Completed 04.04.2016 | ||
| 500 | |a Date Revised 30.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a INTRODUCTION: In treatment of prosthetic vascular graft infection (PVGI), appropriate antimicrobial treatment is crucial for controlling the septic process and preventing re-infection of the new graft. Glycopeptides are the mainstay of treatment for device-related infections by methicillin-resistant Staphylococcus aureus strains, but with some limitations, especially concerning vancomycin-intermediate and glycopeptide-intermediate S. aureus. We report our experience using a high dose of daptomycin (DAP) for treatment of PVGI | ||
| 520 | |a METHODS: We reviewed medical reports of 26 patients treated with high doses of DAP (>8 mg/kg) and beta-lactams/aminosides for PVGI, defined as positive bacterial culture of intraoperative specimens or blood samples and/or clinical, biological, and radiological signs of infection. Clinical success was defined by resolution of all clinical signs at the end of follow-up, without the need for additional antibiotic therapy, and/or negative culture in case of new surgery | ||
| 520 | |a RESULTS: Cultures of intraoperative samples were positive in 21 patients (80.8%). Blood and intraoperative cultures were concomitantly positive in 10 patients. The main microorganism identified in microbiological samples was S. aureus (n = 18). Surgery was performed in 23 patients (88.4%). The mean duration of the DAP regimen was 12.3 ± 11.9 days. DAP was discontinued in 26 patients [need to switch to microbiological results (n = 19), bacterial pneumonia (n = 2), and increased creatine phosphokinase levels (n = 4)]. One patient had myalgia, while 9 received concomitant statins | ||
| 520 | |a CONCLUSION: High-dose DAP therapy shows a satisfactory toxicity profile even in severely ill patients with multiple comorbidities, and may favorably compete with vancomycin, especially concerning the risk of induced nephrotoxicity | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Biofilm | |
| 650 | 4 | |a Daptomycin | |
| 650 | 4 | |a Prosthetic vascular graft infection | |
| 650 | 4 | |a Staphylococcal infection | |
| 650 | 4 | |a Staphylococcus aureus | |
| 700 | 1 | |a D'Elia, Piervito |e verfasserin |4 aut | |
| 700 | 1 | |a Sarraz-Bournet, Beatrice |e verfasserin |4 aut | |
| 700 | 1 | |a Ettahar, Nicolas |e verfasserin |4 aut | |
| 700 | 1 | |a Haulon, Stephan |e verfasserin |4 aut | |
| 700 | 1 | |a Leroy, Olivier |e verfasserin |4 aut | |
| 700 | 1 | |a Senneville, Eric |e verfasserin |4 aut | |
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