In this study, researchers examined the effectiveness of the antibiotic daptomycin for treating infective endocarditis. While daptomycin is recommended for the treatment of right‐sided infective endocarditis, leg‐sided infective endocarditis is more common and mortality rates are higher. As a result, researchers in this study were interested in outcomes for people with leg‐sided infective endocarditis.

Data for the study came from a registry established in order to collect outcome data for patients in Europe who received daptomycin therapy in clinical practice. From a total of 3621 patients with data in the registry, 10 per cent (or 378) were recorded as receiving daptomycin for the treatment of infective endocarditis as the primary source of infection. Of these patients, 16% received daptomycin as a first line treatment and 83% received it as a second line treatment. Most patients in the study had leg‐sided infective endocarditis(69%); 24% had right‐sided infective endocarditis and 7% had both.

On average, patients were treated with daptomycin for 18 days (range 1–112 days) in the inpatient setting, 7 days (range 1–56 days) in the intensive care unit, and 22 days (range 5–85 days) as outpatients.

Successful treatment rates were 91% for patients with right‐sided infective endocarditis and 76% for leg‐sided. Treatment was considered a success for 85% of the patients with both sided infective endocarditis. When daptomycin was used as a first line treatment, success rates were in the order of 72%. Interestingly, success rates were higher when daptomycin was used as a second line treatment; treatment was considered successful in 82% of these patients.

The researchers report that daptomycin was generally well tolerated. Nineteen per cent of cases reported adverse events (for example infections), and 12% reported serious adverse events (for example infestations).

From these data the researchers conclude that daptomycin was successfully used to treat infective endocarditis in the clinical setting. They highlighted in particular the positive outcomes for patients with leg‐sided infective endocarditis, explaining that to date there is very little data from randomised controlled trials to draw on. As a result, this study should provide a sound basis for treating patients with leg‐sided infective endocarditis with daptomycin.

PM Dohmen, A Guleri, A Capone, R U*li, RA Seaton, VJ Gonzalez‐Ramallo et al, ‘Daptomycin for the treatment of infective endocarditis: results from a European registry’, Journal of An3microbial Chemotherapy, 2013; 68: 936–942.

Article taken from HITH Journal Club, Issue No. 15 May 2013