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Daptomycin-based aminoglycoside-sparing therapy for streptococcal endocarditis: a retrospective multicenter study

Carlo Pallotto1,2, Francesco Sbrana3, Andrea Ripoli3

  • 1Section of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, Italy.

Journal of Chemotherapy (Florence, Italy)
|October 26, 2020
PubMed

Insights

Daptomycin-based therapy for streptococcal infective endocarditis (IE) shows promise. This aminoglycoside-sparing approach demonstrated similar efficacy to standard care but significantly reduced acute kidney injury incidence in patients with IE.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Nephrology

Background:

  • Streptococci are common causes of infective endocarditis (IE).
  • Current guidelines recommend beta-lactam/gentamicin therapy for IE, despite potential renal toxicity.
  • Aminoglycoside-associated renal failure is a recognized adverse event.

Purpose of the Study:

  • To evaluate daptomycin-based, aminoglycoside-sparing combination therapy for streptococcal IE.
  • To compare mortality and acute kidney injury (AKI) incidence between standard of care (SoC) and daptomycin-based therapy.

Main Methods:

  • Retrospective, multicenter, observational study.
  • Inclusion of patients with streptococcal IE treated between 2016-2018.
  • Comparison of outcomes between standard of care and daptomycin-based groups.

Main Results:

  • Fifty-four patients were enrolled; 33 received SoC (Group A) and 21 received daptomycin-based therapy (Group B).
  • Mortality was 6% in Group A versus 0% in Group B (p=0.681).
  • AKI incidence was 24% in Group A versus 0% in Group B (p=0.04).

Conclusions:

  • Daptomycin-based aminoglycoside-sparing therapy is a promising alternative for streptococcal IE.
  • This approach offers similar efficacy to standard care with a significantly lower risk of AKI.
  • Further research is warranted to confirm these findings.
Keywords:
Acute kidney injuryAminoglycoside-sparing therapyDaptomycinStreptococcal endocarditisendocarditis

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