Postmarketing Clinical Experience in Patients with Skin and Skin-Structure Infections Treated with Daptomycin

• Published in: The American journal of medicine Vol. 120; no. 10; pp. S6 - S12
• Main Authors: Owens, Robert C., PharmD, Lamp, Kenneth C., PharmD, Friedrich, Lawrence V., PharmD, Russo, Rene, PharmD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2007; Elsevier Sequoia S.A
• Subjects: Adult; Aged; Anti-Bacterial Agents - therapeutic use; Antibiotics; Daptomycin; Daptomycin - therapeutic use; Enterococcus; Female; Gram-positive bacteria; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - microbiology; Humans; Internal Medicine; Male; Medical treatment; Methicillin-resistant Staphylococcus aureus; Middle Aged; Product Surveillance, Postmarketing; Skin; Skin and skin-structure infections; Skin Diseases, Bacterial - drug therapy; Skin Diseases, Bacterial - microbiology; Soft Tissue Infections - drug therapy; Soft Tissue Infections - microbiology; Staphylococcus aureus; Staphylococcus infections; Vancomycin-resistant enterococci; Enterococcus; Skin and skin-structure infections; Methicillin-resistant Staphylococcus aureus; Staphylococcus aureus; Daptomycin; Vancomycin-resistant enterococci
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/j.amjmed.2007.07.009

Abstract A registry describing daptomycin’s clinical use was analyzed to describe treatment of skin and skin-structure infections (SSSIs). The Cubicin Outcomes Registry and Experience (CORE) 2004 retrospectively collected demographic, microbiologic, and clinical outcome information of patients treated with daptomycin (Cubicin; Cubist Pharmaceuticals, Inc., Lexington, MA). The database was accessed to identify patients with a diagnosis of an SSSI with an outcome determined. Of 577 patients identified with a SSSI, 522 (90%) were evaluable. Diabetes mellitus and peripheral vascular disease were present in 27% and 10% of the population, respectively. Pathogens were identified for 65% of all patients— Staphylococcus aureus (75%; 85% methicillin-resistant) and Enterococcus species (19%; 44% vancomycin-resistant) most commonly. Concomitant use of other antibiotics was common (42%). Of 522 patients studied, 334 (64%) had complicated infections (cSSSIs), and 188 (36%) had uncomplicated infections (uSSSIs). Overall cure, improved, and failure rates were 53%, 43%, and 4%, respectively, for cSSSI and 66%, 32%, and 2%, respectively, for uSSSI. The median dose administered was 4.0 mg/kg for cSSSI (mean, 4.5 ± 1.0 mg/kg; range, 2.3 to 12 mg/kg) and 4.0 mg/kg for uSSSI (mean, 4.2 ± 0.8 mg/kg; range, 2.1 to 9 mg/kg); the dose was significantly higher in cSSSI ( P <0.001, median test). Median daptomycin treatment duration was 12 days (range, 1 to 148 days) and was longer for cSSSI than for uSSSI (14 vs. 10 days, P = 0.002). The results of this study support previously published reports and suggest that daptomycin is effective for the treatment of skin infections due to gram-positive pathogens.