Weight-based antibiotic dosing in a real-world European study of complicated skin and soft-tissue infections due to

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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA

Published on: February 9, 2011

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W Lawson1, D Nathwani2, C Eckmann3

  • 1Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|July 25, 2015
PubMed

Insights

Real-world antibiotic dosing for methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft-tissue infections (cSSTIs) in Europe often deviates from labeled recommendations. Many patients received higher or lower doses than standard, potentially impacting treatment outcomes.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Clinical Pharmacy

Background:

  • Methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft-tissue infections (cSSTIs) require effective antibiotic treatment.
  • Intravenous (IV) antibiotic dosing strategies are crucial for managing severe MRSA cSSTIs.
  • Understanding real-world antibiotic administration practices is essential for optimizing patient care.

Purpose of the Study:

  • To characterize the actual weight-based IV antibiotic dosing regimens used in hospitalized patients with MRSA cSSTIs across 12 European countries.
  • To compare real-world dosing of vancomycin, teicoplanin, and daptomycin against their labeled recommendations for MRSA cSSTIs.
  • To identify deviations in antibiotic dosing and their potential implications for patient outcomes.

Main Methods:

  • Retrospective chart review of patients hospitalized with MRSA cSSTIs between July 2010 and June 2011.
  • Inclusion of patients treated with IV vancomycin, teicoplanin, or daptomycin.
  • Analysis of dosing regimens (mg/kg, frequency, total daily dose) at both regimen and patient levels, categorizing doses as low, standard, or high.

Main Results:

  • Analysis included 998 patients and 1050 antibiotic regimens.
  • Mean total daily doses (TDDs) were 6.3 mg/kg for daptomycin, 10.5 mg/kg for teicoplanin, and 28.5 mg/kg for vancomycin.
  • A high percentage of patients received higher-than-labeled doses for teicoplanin (96%) and daptomycin (80%), while over 40% received lower-than-labeled vancomycin doses.

Conclusions:

  • Significant deviations from labeled antibiotic dosing practices for MRSA cSSTIs were observed in real-world European settings.
  • The observed dosing variations, including both supra- and sub-therapeutic levels, may lead to suboptimal clinical outcomes.
  • Further research is warranted to establish optimal dosing strategies and their impact on treatment efficacy and safety.
Keywords:
Complicated skin and soft-tissue infectiondaptomycindosingmethicillin-resistant Staphylococcus aureusteicoplaninvancomycin

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