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

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.