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A potential role for daptomycin in enterococcal infections: what is the evidence?

Rafael Cantón1, Patricia Ruiz-Garbajosa, Ricardo L Chaves

  • 1Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain. rcanton.hrc@salud.madrid.org

The Journal of Antimicrobial Chemotherapy
|April 6, 2010
PubMed

Insights

Daptomycin offers an effective treatment for challenging enterococcal infections, even those resistant to other antibiotics. Its unique mechanism provides broad activity against these difficult-to-treat Gram-positive bacteria.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Microbiology

Background:

  • Nosocomial enterococcal infections pose treatment challenges due to multidrug resistance, including vancomycin resistance.
  • Daptomycin, a cyclic lipopeptide, is effective against Gram-positive bacteria and has shown promise for enterococcal infections.
  • Enterococci are a significant cause of hospital-acquired infections, often exhibiting resistance to common antibiotics.

Purpose of the Study:

  • To review the efficacy and clinical utility of daptomycin in treating enterococcal infections.
  • To highlight daptomycin's activity against multidrug-resistant enterococci.
  • To summarize clinical experience and evidence supporting daptomycin use in enterococcal infections.

Main Methods:

  • Literature review of large-scale susceptibility studies.
  • Analysis of clinical experience and case reports.
  • Examination of daptomycin's distinct mechanism of action compared to other antibiotics.

Main Results:

  • Daptomycin demonstrates potent bactericidal activity against enterococci in vitro and in vivo.
  • Over 98% of tested enterococcal strains are susceptible to daptomycin, regardless of resistance to other agents.
  • Clinical data support daptomycin's efficacy across various enterococcal infection types, including bacteremia and endocarditis.

Conclusions:

  • Daptomycin is a valuable therapeutic option for enterococcal infections, particularly those with limited treatment alternatives.
  • Its unique mechanism of action results in a lack of cross-resistance with other antibiotic classes.
  • Extensive clinical experience supports the use of daptomycin for a range of enterococcal infections.

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