Suppr超能文献

多中心评估伴有和不伴有合并使用β-内酰胺类药物的达托霉素在合并轻中度肾功能损害的金黄色葡萄球菌菌血症患者中的临床结局。

Multicenter evaluation of the clinical outcomes of daptomycin with and without concomitant β-lactams in patients with Staphylococcus aureus bacteremia and mild to moderate renal impairment.

机构信息

Department of Medical Affairs, Cubist Pharmaceuticals, Lexington, MA, USA.

出版信息

Antimicrob Agents Chemother. 2013 Mar;57(3):1192-200. doi: 10.1128/AAC.02192-12. Epub 2012 Dec 17.

Abstract

Patients with underlying renal disease may be vulnerable to vancomycin-mediated nephrotoxicity and Staphylococcus aureus bacteremia treatment failure. In light of recent data demonstrating the successful use of β-lactam plus daptomycin in very difficult cases of S. aureus bacteremia, we examined safety and clinical outcomes for patients who received daptomycin with or without concomitant β-lactams. We identified 106 patients who received daptomycin for S. aureus bacteremia, had mild or moderate renal insufficiency according to FDA criteria, and enrolled in the Cubicin Outcomes Registry and Experience (CORE), a multicenter registry, from 2005 to 2009. Daptomycin treatment success was 81%. Overall treatment efficacy was slightly enhanced with the addition of a β-lactam (87% versus 78%; P = 0.336), but this trend was most pronounced for bacteremia associated with endocarditis or bone/joint infection or bacteremia from an unknown source (90% versus 57%; P = 0.061). Factors associated with reduced daptomycin efficacy (by logistic regression) were an unknown source of bacteremia (odds ratio [OR] = 7.59; 95% confidence interval [CI] = 1.55 to 37.2), moderate renal impairment (OR = 9.11; 95% CI = 1.46 to 56.8), and prior vancomycin failure (OR = 11.2; 95% CI = 1.95 to 64.5). Two patients experienced an increase in creatine phosphokinase (CPK) that resolved after stopping daptomycin. No patients developed worsening renal insufficiency related to daptomycin. In conclusion, daptomycin appeared to be effective and well tolerated in patients with S. aureus bacteremia and mild to moderate renal insufficiency. Daptomycin treatment efficacy might be enhanced with β-lactam combination therapy in primary endovascular and bone/joint infections. Additional studies will be necessary to confirm these findings.

摘要

患有基础肾脏疾病的患者可能容易发生万古霉素介导的肾毒性和金黄色葡萄球菌菌血症治疗失败。鉴于最近的数据表明,β-内酰胺联合达托霉素在非常困难的金黄色葡萄球菌菌血症病例中取得了成功,我们检查了接受达托霉素联合或不联合β-内酰胺治疗的患者的安全性和临床结局。我们确定了 106 名根据 FDA 标准患有轻度或中度肾功能不全的金黄色葡萄球菌菌血症患者,他们参加了 Cubicin Outcomes Registry and Experience(CORE),这是一项多中心注册研究,时间为 2005 年至 2009 年。达托霉素治疗成功率为 81%。总体治疗效果略有提高,β-内酰胺的加入(87%对 78%;P=0.336),但对于与心内膜炎或骨/关节感染或不明来源菌血症相关的菌血症,这种趋势更为明显(90%对 57%;P=0.061)。通过逻辑回归与降低达托霉素疗效相关的因素是菌血症的不明来源(比值比[OR] = 7.59;95%置信区间[CI] = 1.55 至 37.2),中度肾功能不全(OR = 9.11;95%CI = 1.46 至 56.8),以及万古霉素治疗失败(OR = 11.2;95%CI = 1.95 至 64.5)。有 2 名患者的肌酸磷酸激酶(CPK)升高,停用达托霉素后恢复正常。没有患者因达托霉素而出现肾功能不全加重。总之,达托霉素在金黄色葡萄球菌菌血症和轻度至中度肾功能不全患者中似乎是有效且耐受良好的。β-内酰胺联合治疗可能会增强达托霉素治疗原发性血管内和骨/关节感染的疗效。需要进一步的研究来证实这些发现。

相似文献

3
Daptomycin versus standard therapy for bacteremia and endocarditis caused by Staphylococcus aureus.
N Engl J Med. 2006 Aug 17;355(7):653-65. doi: 10.1056/NEJMoa053783.
5
Evaluation of Daptomycin Exposure and Efficacy and Safety Endpoints To Support Risk-versus-Benefit Considerations.
Antimicrob Agents Chemother. 2015 Dec 28;60(3):1600-7. doi: 10.1128/AAC.02967-15.
7
Clinical Outcomes of Daptomycin for Vancomycin-resistant Enterococcus Bacteremia.
Clin Ther. 2015 Jul 1;37(7):1443-1453.e2. doi: 10.1016/j.clinthera.2015.04.008. Epub 2015 May 15.
8
Combination of Vancomycin or Daptomycin and Beta-lactam Antibiotics: A Meta-analysis.
Pharmacotherapy. 2020 Jul;40(7):648-658. doi: 10.1002/phar.2437. Epub 2020 Jul 6.

引用本文的文献

2
Adjunctive β-lactams for bacteremia: a narrative review.
Ther Adv Infect Dis. 2025 Jun 14;12:20499361251343969. doi: 10.1177/20499361251343969. eCollection 2025 Jan-Dec.
3
PBP4 is required for serum-induced cell wall thickening and antibiotic tolerance in .
Antimicrob Agents Chemother. 2024 Nov 6;68(11):e0096124. doi: 10.1128/aac.00961-24. Epub 2024 Oct 21.
6
New advances in management and treatment of cardiac implantable electronic devices infections.
Infection. 2024 Apr;52(2):323-336. doi: 10.1007/s15010-023-02130-8. Epub 2023 Nov 24.
7
RNA-Seq-based transcriptome analysis of methicillin-resistant growth inhibition by propionate.
Front Microbiol. 2022 Dec 22;13:1063650. doi: 10.3389/fmicb.2022.1063650. eCollection 2022.
9
Human serum triggers antibiotic tolerance in Staphylococcus aureus.
Nat Commun. 2022 Apr 19;13(1):2041. doi: 10.1038/s41467-022-29717-3.
10
The Role of Mutations in Seesaw Effect of Daptomycin-Resistant Methicillin-Resistant Staphylococcus aureus Isolates.
Antimicrob Agents Chemother. 2022 Jan 18;66(1):e0129521. doi: 10.1128/AAC.01295-21. Epub 2021 Oct 18.

本文引用的文献

6
Predictors of mortality in Staphylococcus aureus Bacteremia.
Clin Microbiol Rev. 2012 Apr;25(2):362-86. doi: 10.1128/CMR.05022-11.
8
Relationship between vancomycin trough concentrations and nephrotoxicity: a prospective multicenter trial.
Antimicrob Agents Chemother. 2011 Dec;55(12):5475-9. doi: 10.1128/AAC.00168-11. Epub 2011 Sep 26.
10
Vancomycin: we can't get there from here.
Clin Infect Dis. 2011 Apr 15;52(8):969-74. doi: 10.1093/cid/cir078.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验