Related Experiment Video

Updated: Jan 15, 2026

In Vivo Mouse Model of Spinal Implant Infection
08:03

In Vivo Mouse Model of Spinal Implant Infection

Published on: June 23, 2020

2.7K

Association between daptomycin dosing and in-hospital mortality in patients with vancomycin-resistant Enterococcus

Kelly A Cairns1,2, Iain J Abbott1,3,4, Andrew A Udy5,6

  • 1Department of Infectious Diseases, The Alfred Hospital and School of Translational Medicine, Monash University, Melbourne, Australia.

Jac-Antimicrobial Resistance
|October 13, 2025
PubMed
Abstract

Insights

Optimal daptomycin dosing for vancomycin-resistant Enterococcus faecium bloodstream infections remains unclear. This study found no link between daptomycin dose and mortality, but microbiological failure was associated with lower doses.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Clinical Microbiology

Background:

  • Vancomycin-resistant Enterococcus faecium (VREfm) bloodstream infections (BSIs) present significant treatment challenges.
  • Optimal daptomycin dosing strategies for VREfm BSIs require further investigation.

Purpose of the Study:

  • To assess the association between daptomycin dose and 30-day in-hospital mortality in adult patients with VREfm BSIs.
  • To evaluate other clinical outcomes, including microbiological failure and length of stay.
  • To compare mortality and outcomes between daptomycin and teicoplanin for vanB VREfm BSIs.

Main Methods:

  • Retrospective cohort study of 191 adult patients with VREfm BSIs treated between 2015 and 2022.
  • Daptomycin doses categorized as low (≤7.9 mg/kg), medium (8.0-9.9 mg/kg), or high (≥10 mg/kg).
  • Comparative analysis of mortality and outcomes for vanB VREfm BSIs treated with daptomycin versus teicoplanin.

Main Results:

  • No significant association was found between daptomycin dose groups and 30-day in-hospital mortality (P=.369).
  • Microbiological failure rates varied by dose: 33.3% (low), 12.1% (medium), and 19.7% (high) (P=.036).
  • No mortality difference observed between daptomycin and teicoplanin for vanB VREfm BSIs (aHR=0.67; 95% CI: 0.28-1.59).

Conclusions:

  • In contemporary practice with predominantly high daptomycin doses, dose escalation did not impact 30-day mortality for VREfm BSIs.
  • Daptomycin dose was associated with microbiological failure, suggesting potential benefits of higher doses.
  • Daptomycin and teicoplanin showed comparable mortality for vanB VREfm BSIs.

More Related Videos

A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically11:28

A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically

Published on: September 9, 2015

29.7K
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

13.4K

Related Concept Videos

Estimation of k and VD of Aminoglycosides01:20

Estimation of k and VD of Aminoglycosides

Aminoglycosides are a class of antibiotics used to treat various bacterial infections. Clinicians must determine the elimination rate constant (k) and volume of distribution (VD) to optimize therapeutic efficacy and minimize toxicity. The k value represents the rate at which the drug is removed from the body, and the VD reflects the degree to which the drug distributes into body tissues. Accurately estimating these parameters allows healthcare professionals to tailor drug dosing to individual...
213
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
235
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
232
Dosage Interval and Administration Route: Determination Methods01:19

Dosage Interval and Administration Route: Determination Methods

A medication’s effectiveness largely depends on its appropriate dosage and the route of administration. Dosage ensures that a sufficient drug concentration is maintained in the bloodstream to elicit the desired therapeutic effect without causing toxicity. The route of administration affects the drug's bioavailability, rate of absorption, and onset of action, which are crucial for achieving optimal therapeutic outcomes. Drug dosage calculations are critical to tailoring therapy to...
225
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
225
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
208