Daptomycin Compared to Vancomycin for the Treatment of Osteomyelitis: A Single-Center, Retrospective Cohort Study
Abstract Background Osteomyelitis (OM) is a serious infection with high rates of recurrence. Vancomycin has been used for decades in the treatment of OM, but, despite adequate dosing, 30% to 50% of patients experience infection recurrence within 12 months. Daptomycin, a novel lipopetide antibiotic,...
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| Veröffentlicht in: | Clinical therapeutics 2012-07, Vol.34 (7), p.1521-1527 |
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| creator | Moenster, Ryan P., PharmD Linneman, Travis W., PharmD Finnegan, Patrick M., PharmD McDonald, Jay R., MD |
| description | Abstract Background Osteomyelitis (OM) is a serious infection with high rates of recurrence. Vancomycin has been used for decades in the treatment of OM, but, despite adequate dosing, 30% to 50% of patients experience infection recurrence within 12 months. Daptomycin, a novel lipopetide antibiotic, is also active against resistant gram-positive organisms, but there is little published about its efficacy and tolerability in the treatment of OM. Objective Our aim was to compare the recurrence rates of OM in patients treated with daptomycin or vancomycin. Methods A retrospective cohort study of all patients at a VA Medical Center between January 1, 2003, and July 31, 2009, who received daptomycin for the treatment of OM was undertaken. Patients with a diagnosis of OM who received at least 2 weeks of daptomycin and had at least 1 follow-up visit within 6 months after completion of therapy were included. Each patient was matched with 2 controls treated with at least 2 weeks of vancomycin for OM. Matching criteria included previous OM, diabetes, peripheral vascular disease, hardware involvement, and surgical therapy. Patients were excluded from the evaluation if they received |
| doi_str_mv | 10.1016/j.clinthera.2012.06.013 |
| format | Article |
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Vancomycin has been used for decades in the treatment of OM, but, despite adequate dosing, 30% to 50% of patients experience infection recurrence within 12 months. Daptomycin, a novel lipopetide antibiotic, is also active against resistant gram-positive organisms, but there is little published about its efficacy and tolerability in the treatment of OM. Objective Our aim was to compare the recurrence rates of OM in patients treated with daptomycin or vancomycin. Methods A retrospective cohort study of all patients at a VA Medical Center between January 1, 2003, and July 31, 2009, who received daptomycin for the treatment of OM was undertaken. Patients with a diagnosis of OM who received at least 2 weeks of daptomycin and had at least 1 follow-up visit within 6 months after completion of therapy were included. Each patient was matched with 2 controls treated with at least 2 weeks of vancomycin for OM. Matching criteria included previous OM, diabetes, peripheral vascular disease, hardware involvement, and surgical therapy. Patients were excluded from the evaluation if they received <14 days of therapy, had no follow-up in the 6 months after therapy was discontinued, had an absolute neutrophil count <500 cells/mm3 , or were receiving vancomycin and daptomycin concurrently. The primary outcome was recurrence of infection within 6 months after the discontinuation of therapy. Secondary outcomes included mean change in creatine phosphokinase (CPK), incident thrombocytopenia, and mean doses of antibiotics. The χ2 test was used to compare rates of recurrence between groups. Results Seventeen patients received at least 2 weeks of daptomycin for the treatment of OM and were matched to 34 vancomycin controls. Twenty-nine percent of patients receiving daptomycin had a recurrence of infection compared with 61.7% in the vancomycin group ( P = 0.029). The mean change in CPK for the daptomycin group was +28.8 U/L. No thrombocytopenia developed in any patients receiving daptomycin compared with 2 (5.9%) patients in the vancomycin group. Conclusions In a limited number of cases, significantly fewer patients treated with daptomycin for OM had a recurrence of their infection. Daptomycin may be a tolerable and effective alternative to vancomycin for the treatment of OM.</description><identifier>ISSN: 0149-2918</identifier><identifier>EISSN: 1879-114X</identifier><identifier>DOI: 10.1016/j.clinthera.2012.06.013</identifier><identifier>PMID: 22748973</identifier><language>eng</language><publisher>Bridgewater, NJ: EM Inc USA</publisher><subject>Anti-Bacterial Agents - adverse effects ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Bacterial arthritis and osteitis ; Bacterial diseases ; Biological and medical sciences ; Cohort Studies ; daptomycin ; Daptomycin - adverse effects ; Daptomycin - therapeutic use ; Disease ; Drug therapy ; FDA approval ; Follow-Up Studies ; Hospitals, Veterans ; Human bacterial diseases ; Humans ; Infectious diseases ; Internal Medicine ; long-term antibiotics ; Male ; Medical Education ; Medical sciences ; Middle Aged ; Mortality ; osteomyelitis ; Osteomyelitis - drug therapy ; Pharmacology. Drug treatments ; Recurrence ; Retrospective Studies ; Staphylococcus infections ; Treatment Outcome ; vancomycin ; Vancomycin - adverse effects ; Vancomycin - therapeutic use</subject><ispartof>Clinical therapeutics, 2012-07, Vol.34 (7), p.1521-1527</ispartof><rights>Elsevier HS Journals, Inc.</rights><rights>2012 Elsevier HS Journals, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c484t-93d4509f01b7111a00f6f969c4d083911da067fd5c06e7c37aab3d844d78261c3</citedby><cites>FETCH-LOGICAL-c484t-93d4509f01b7111a00f6f969c4d083911da067fd5c06e7c37aab3d844d78261c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1036627179?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26185060$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22748973$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Moenster, Ryan P., PharmD</creatorcontrib><creatorcontrib>Linneman, Travis W., PharmD</creatorcontrib><creatorcontrib>Finnegan, Patrick M., PharmD</creatorcontrib><creatorcontrib>McDonald, Jay R., MD</creatorcontrib><title>Daptomycin Compared to Vancomycin for the Treatment of Osteomyelitis: A Single-Center, Retrospective Cohort Study</title><title>Clinical therapeutics</title><addtitle>Clin Ther</addtitle><description>Abstract Background Osteomyelitis (OM) is a serious infection with high rates of recurrence. Vancomycin has been used for decades in the treatment of OM, but, despite adequate dosing, 30% to 50% of patients experience infection recurrence within 12 months. Daptomycin, a novel lipopetide antibiotic, is also active against resistant gram-positive organisms, but there is little published about its efficacy and tolerability in the treatment of OM. Objective Our aim was to compare the recurrence rates of OM in patients treated with daptomycin or vancomycin. Methods A retrospective cohort study of all patients at a VA Medical Center between January 1, 2003, and July 31, 2009, who received daptomycin for the treatment of OM was undertaken. Patients with a diagnosis of OM who received at least 2 weeks of daptomycin and had at least 1 follow-up visit within 6 months after completion of therapy were included. Each patient was matched with 2 controls treated with at least 2 weeks of vancomycin for OM. Matching criteria included previous OM, diabetes, peripheral vascular disease, hardware involvement, and surgical therapy. Patients were excluded from the evaluation if they received <14 days of therapy, had no follow-up in the 6 months after therapy was discontinued, had an absolute neutrophil count <500 cells/mm3 , or were receiving vancomycin and daptomycin concurrently. The primary outcome was recurrence of infection within 6 months after the discontinuation of therapy. Secondary outcomes included mean change in creatine phosphokinase (CPK), incident thrombocytopenia, and mean doses of antibiotics. The χ2 test was used to compare rates of recurrence between groups. Results Seventeen patients received at least 2 weeks of daptomycin for the treatment of OM and were matched to 34 vancomycin controls. Twenty-nine percent of patients receiving daptomycin had a recurrence of infection compared with 61.7% in the vancomycin group ( P = 0.029). The mean change in CPK for the daptomycin group was +28.8 U/L. No thrombocytopenia developed in any patients receiving daptomycin compared with 2 (5.9%) patients in the vancomycin group. Conclusions In a limited number of cases, significantly fewer patients treated with daptomycin for OM had a recurrence of their infection. Daptomycin may be a tolerable and effective alternative to vancomycin for the treatment of OM.</description><subject>Anti-Bacterial Agents - adverse effects</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Bacterial arthritis and osteitis</subject><subject>Bacterial diseases</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>daptomycin</subject><subject>Daptomycin - adverse effects</subject><subject>Daptomycin - therapeutic use</subject><subject>Disease</subject><subject>Drug therapy</subject><subject>FDA approval</subject><subject>Follow-Up Studies</subject><subject>Hospitals, Veterans</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Internal Medicine</subject><subject>long-term antibiotics</subject><subject>Male</subject><subject>Medical Education</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>osteomyelitis</subject><subject>Osteomyelitis - drug therapy</subject><subject>Pharmacology. Drug treatments</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Staphylococcus infections</subject><subject>Treatment Outcome</subject><subject>vancomycin</subject><subject>Vancomycin - adverse effects</subject><subject>Vancomycin - therapeutic use</subject><issn>0149-2918</issn><issn>1879-114X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkk1r3DAQhk1pabZp_0IrKIUealdjeyUrh8KyST8gEOimpTehlcaNtrblSHJg_31ldptATj0JNM-88_FOlr0BWgAF9nFX6M4O8Qa9KkoKZUFZQaF6ki2g4SIHqH89zRYUapGXApqT7EUIO0ppJZbl8-ykLHndCF4tsttzNUbX77UdyNr1o_JoSHTkpxr08bt1nqRK5Nqjij0OkbiWXIWIKY6djTackRXZ2OF3h_k6xdF_IN8xehdG1NHeYVK-cT6STZzM_mX2rFVdwFfH9zT78fniev01v7z68m29usx13dQxF5Wpl1S0FLYcABSlLWsFE7o2tKkEgFGU8dYsNWXIdcWV2lamqWvDm5KBrk6z9wfd0bvbCUOUvQ0au04N6KYggZaMJUEhEvr2Ebpzkx9Sd4mqGCs58JniB0qnyYLHVo7e9srvEyRnV-RO3rsiZ1ckZTK5kjJfH_WnbY_mPu-fDQl4dwRU0Kprfdq-DQ8cg2ZJGU3c6sBhWtydRS-DtjhoNNanVUvj7H808-mRxszZVPYP7jE8TC5DypGb-YjmG4IynQ9nUP0FfVDDvw</recordid><startdate>20120701</startdate><enddate>20120701</enddate><creator>Moenster, Ryan P., PharmD</creator><creator>Linneman, Travis W., PharmD</creator><creator>Finnegan, Patrick M., PharmD</creator><creator>McDonald, Jay R., MD</creator><general>EM Inc USA</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120701</creationdate><title>Daptomycin Compared to Vancomycin for the Treatment of Osteomyelitis: A Single-Center, Retrospective Cohort Study</title><author>Moenster, Ryan P., PharmD ; Linneman, Travis W., PharmD ; Finnegan, Patrick M., PharmD ; McDonald, Jay R., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c484t-93d4509f01b7111a00f6f969c4d083911da067fd5c06e7c37aab3d844d78261c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Anti-Bacterial Agents - adverse effects</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Bacterial arthritis and osteitis</topic><topic>Bacterial diseases</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>daptomycin</topic><topic>Daptomycin - adverse effects</topic><topic>Daptomycin - therapeutic use</topic><topic>Disease</topic><topic>Drug therapy</topic><topic>FDA approval</topic><topic>Follow-Up Studies</topic><topic>Hospitals, Veterans</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Internal Medicine</topic><topic>long-term antibiotics</topic><topic>Male</topic><topic>Medical Education</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>osteomyelitis</topic><topic>Osteomyelitis - drug therapy</topic><topic>Pharmacology. Drug treatments</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Staphylococcus infections</topic><topic>Treatment Outcome</topic><topic>vancomycin</topic><topic>Vancomycin - adverse effects</topic><topic>Vancomycin - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moenster, Ryan P., PharmD</creatorcontrib><creatorcontrib>Linneman, Travis W., PharmD</creatorcontrib><creatorcontrib>Finnegan, Patrick M., PharmD</creatorcontrib><creatorcontrib>McDonald, Jay R., MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moenster, Ryan P., PharmD</au><au>Linneman, Travis W., PharmD</au><au>Finnegan, Patrick M., PharmD</au><au>McDonald, Jay R., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Daptomycin Compared to Vancomycin for the Treatment of Osteomyelitis: A Single-Center, Retrospective Cohort Study</atitle><jtitle>Clinical therapeutics</jtitle><addtitle>Clin Ther</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>34</volume><issue>7</issue><spage>1521</spage><epage>1527</epage><pages>1521-1527</pages><issn>0149-2918</issn><eissn>1879-114X</eissn><abstract>Abstract Background Osteomyelitis (OM) is a serious infection with high rates of recurrence. Vancomycin has been used for decades in the treatment of OM, but, despite adequate dosing, 30% to 50% of patients experience infection recurrence within 12 months. Daptomycin, a novel lipopetide antibiotic, is also active against resistant gram-positive organisms, but there is little published about its efficacy and tolerability in the treatment of OM. Objective Our aim was to compare the recurrence rates of OM in patients treated with daptomycin or vancomycin. Methods A retrospective cohort study of all patients at a VA Medical Center between January 1, 2003, and July 31, 2009, who received daptomycin for the treatment of OM was undertaken. Patients with a diagnosis of OM who received at least 2 weeks of daptomycin and had at least 1 follow-up visit within 6 months after completion of therapy were included. Each patient was matched with 2 controls treated with at least 2 weeks of vancomycin for OM. Matching criteria included previous OM, diabetes, peripheral vascular disease, hardware involvement, and surgical therapy. Patients were excluded from the evaluation if they received <14 days of therapy, had no follow-up in the 6 months after therapy was discontinued, had an absolute neutrophil count <500 cells/mm3 , or were receiving vancomycin and daptomycin concurrently. The primary outcome was recurrence of infection within 6 months after the discontinuation of therapy. Secondary outcomes included mean change in creatine phosphokinase (CPK), incident thrombocytopenia, and mean doses of antibiotics. The χ2 test was used to compare rates of recurrence between groups. Results Seventeen patients received at least 2 weeks of daptomycin for the treatment of OM and were matched to 34 vancomycin controls. Twenty-nine percent of patients receiving daptomycin had a recurrence of infection compared with 61.7% in the vancomycin group ( P = 0.029). The mean change in CPK for the daptomycin group was +28.8 U/L. No thrombocytopenia developed in any patients receiving daptomycin compared with 2 (5.9%) patients in the vancomycin group. Conclusions In a limited number of cases, significantly fewer patients treated with daptomycin for OM had a recurrence of their infection. Daptomycin may be a tolerable and effective alternative to vancomycin for the treatment of OM.</abstract><cop>Bridgewater, NJ</cop><pub>EM Inc USA</pub><pmid>22748973</pmid><doi>10.1016/j.clinthera.2012.06.013</doi><tpages>7</tpages></addata></record> |
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| subjects | Anti-Bacterial Agents - adverse effects Anti-Bacterial Agents - therapeutic use Antibiotics Bacterial arthritis and osteitis Bacterial diseases Biological and medical sciences Cohort Studies daptomycin Daptomycin - adverse effects Daptomycin - therapeutic use Disease Drug therapy FDA approval Follow-Up Studies Hospitals, Veterans Human bacterial diseases Humans Infectious diseases Internal Medicine long-term antibiotics Male Medical Education Medical sciences Middle Aged Mortality osteomyelitis Osteomyelitis - drug therapy Pharmacology. Drug treatments Recurrence Retrospective Studies Staphylococcus infections Treatment Outcome vancomycin Vancomycin - adverse effects Vancomycin - therapeutic use |
| title | Daptomycin Compared to Vancomycin for the Treatment of Osteomyelitis: A Single-Center, Retrospective Cohort Study |
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