Daptomycin in the treatment of bacteraemia: clinical experience in Europe

Abstract number: P1228

Galloway A., Galván-Guijo B., Gonzalez-Ruiz A., Rodríguez A., Almirante B., Lejko-Zupanc T., González-Ramallo V.J., Lampreabe Gaztelu I., Heep M., Thurston H.J., Chaves R.L.

Objective: Daptomycin (DAP) is approved in Europe for the treatment of Staphylococcus aureus bacteraemia at a dose of 6 mg/kg once daily. Limited data are available for the treatment of bacteraemia in clinical practice. The aim of this registry was to describe the clinical experience with DAP for the treatment of bacteraemia.

Methods: The European Cubicin^® Outcomes Registry and Experience (EU-CORE) is a retrospective analysis of patients' clinical outcomes with DAP therapy. Only those patients (pts) with bacteraemia who were treated with at least one dose of DAP were evaluated. Outcomes were assessed by the investigator (cured, improved, failure, non-evaluable) at the end of DAP therapy.

Results: Of the total of 1454 pts in the EU-CORE registry from Sept 2008 to Aug 2009 bacteraemia was diagnosed in 308 pts (21%), of which 53% were catheter related. Patients with bacteraemia were identified with the following demographics: male 71%; age 65 years 47%. In total 39% of pts (120/308) received DAP in an ICU. Concomitant antibiotics were received by 72% of inpatients, most commonly with carbapenems (29%) and penicillins (22%). For 259 pts (84%) primary pathogens have been reported. Coagulase-negative Staphylococci (109/259) ranked first. S. aureus (97/259) was the second most frequent species, with MRSA (n = 45) a significant subset. Enterococcus spp. were seen in 23 cases. Most frequently used initial dose of DAP was 6 mg/kg (75%).

The overall clinical success rate with DAP therapy was 74% (cure or improved). Outcomes of the primary infection for catheter related bacteraemia were: clinical success 76%, failure 11%, and non-evaluable 13%. For non-catheter related bacteraemia: clinical success 72%, failure 14% and non-evaluable 14%. Adverse events (AEs) regardless of the study drug relationship which led to study drug discontinuation were reported in 4% of pts. Serious AEs, regardless of relationship, were reported in 12% of pts.

Conclusion: DAP was effective and well tolerated for the treatment of Gram-positive catheter related bacteraemia and non-catheter related bacteraemia.