达托霉素在人类免疫缺陷病毒患者及耐药革兰氏阳性菌感染中的应用经验。
Daptomycin experience in patients with human immunodeficiency virus and resistant gram-positive infections.
作者信息
Slim Jihad, Jimenez Humberto, Culshaw Darren, Patel Hina, Lamp Kenneth C
机构信息
Saint Michael's Medical Center, Infectious Diseases Department Newark, NJ, USA.
JFK Medical Center, Comprehensive Pharmacy Services Edison, NJ, USA.
出版信息
J Int Assoc Provid AIDS Care. 2015 May-Jun;14(3):202-6. doi: 10.1177/2325957414553840. Epub 2014 Oct 15.
OBJECTIVES
This study was conducted to evaluate the clinical experience with daptomycin in the treatment of resistant gram-positive infections (GPIs) in patients with HIV infection.
METHODS
Using a retrospective, multicenter, and observational registry study, investigators assessed outcomes following daptomycin therapy in 78 patients (62 efficacy evaluable) infected with HIV and with resistant GPIs.
RESULTS
Overall, success rates by infection type were bacteremia 91% (20 of 22), endocarditis 91% (10 of 11), and bone/joint 100% (9 of 9). Success by pathogen was 93% (39 of 42), 93% (14 of 15), and 100% (5 of 5) for methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and methicillin-resistant coagulase-negative staphylococci, respectively. Daptomycin appeared to be well tolerated, with 9% having an adverse event possibly related to daptomycin and 4% discontinuing daptomycin.
CONCLUSIONS
In HIV-infected patients, daptomycin appears to be a useful agent for treating resistant GPIs.
目的
本研究旨在评估达托霉素治疗HIV感染患者耐药革兰氏阳性菌感染（GPI）的临床经验。
方法
采用回顾性、多中心观察性注册研究，研究者评估了78例感染HIV且患有耐药GPI的患者接受达托霉素治疗后的结局（62例可评估疗效）。
结果
总体而言，按感染类型划分的成功率分别为：菌血症91%（22例中的20例）、心内膜炎91%（11例中的10例）、骨/关节感染100%（9例中的9例）。按病原体划分的成功率分别为：耐甲氧西林金黄色葡萄球菌93%（42例中的39例）、耐万古霉素肠球菌93%（15例中的14例）、耐甲氧西林凝固酶阴性葡萄球菌100%（5例中的5例）。达托霉素耐受性良好，9%的患者出现可能与达托霉素相关的不良事件，4%的患者停用达托霉素。
结论
在HIV感染患者中，达托霉素似乎是治疗耐药GPI的有效药物。
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