Department of Clinical Microbiology and Infection Control, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TH, UK.
Eur J Clin Microbiol Infect Dis. 2011 Jun;30(6):807-12. doi: 10.1007/s10096-011-1160-y. Epub 2011 Feb 15.
Infective endocarditis (IE) is a serious form of infection with a high mortality. Medical management can be a challenge because of organ dysfunction, lack of clinical response or allergy to the recommended antibiotics. Daptomycin is a lipopeptide antibiotic with a potent bactericidal activity against Gram-positive bacteria. There are limited data on the use of daptomycin in complicated cases of IE. We aim to report our experience of daptomycin use in complicated cases of IE through a prospective observational study (from 1 October 2008 to 30 September 2009). Daptomycin was prescribed for cases that were either unresponsive or allergic to the standard therapy. Clinical characteristics and outcomes were reviewed. Success was defined as clinical improvement accompanied with the resolution of laboratory markers of sepsis and continuation of the above findings for at least 8 weeks after the end of therapy. Eight cases were evaluable. Native and prosthetic valves were involved in equal proportions. The range of organisms was wide: Staphylococcus aureus, two cases; S. epidermidis, two cases; streptococci, two cases; and Enterococcus faecalis, two cases. The median duration of therapy was 42 days. All patients were successfully treated. Daptomycin was well tolerated. Daptomycin is useful in the management of complicated cases of IE.
感染性心内膜炎（IE）是一种严重的感染形式，死亡率很高。由于器官功能障碍、临床反应不佳或对推荐的抗生素过敏，医学治疗可能具有挑战性。达托霉素是一种脂肽抗生素，对革兰氏阳性菌具有强大的杀菌活性。关于达托霉素在复杂 IE 病例中的应用，数据有限。我们旨在通过前瞻性观察研究（2008 年 10 月 1 日至 2009 年 9 月 30 日）报告我们在复杂 IE 病例中使用达托霉素的经验。达托霉素用于对标准治疗无反应或过敏的病例。回顾了临床特征和结局。成功定义为临床改善伴有败血症的实验室标志物的解决，并且在治疗结束后至少 8 周内继续上述发现。8 例可评估。涉及原生和人工瓣膜的比例相等。病原体范围很广：金黄色葡萄球菌，2 例；表皮葡萄球菌，2 例；链球菌，2 例；粪肠球菌，2 例。治疗的中位持续时间为 42 天。所有患者均成功治疗。达托霉素耐受良好。达托霉素可有效治疗复杂 IE 病例。
