Empirical therapy for serious Gram-positive infections: making the right choice

It is well established that delaying the administration of effective antimicrobials for the treatment of serious infections has a significant impact on patient outcomes. In this atmosphere of urgency, decision-making regarding therapy is further complicated by the current high rates of drug resistance among important pathogens, such as Staphylococcus aureus. To improve treatment outcomes, decrease the risk of mortality and reduce hospital costs, physicians should always administer the most appropriate antimicrobial for the given scenario. When a staphylococcal infection is suspected but the resistance phenotype is not known, agents that are effective against methicillin-susceptible S. aureus and methicillin-resistant S. aureus provide optimal empirical coverage. However, the number of such empirical monotherapeutic options is limited. Daptomycin has proven clinical efficacy as compared with comparator agents in Gram-positive infections, and could be considered an appropriate therapy for the treatment of infections caused by either methicillin-susceptible S. aureus or methicillin-resistant S. aureus.