Safety of High‐Dose Intravenous Daptomycin Treatment: Three‐Year Cumulative Experience in a Clinical Program

作者：Deborah A. Figueroa, Elisabetta Mangini, Maria I Amodio-Groton, B. Vardianos, Alessandra MELCHERT, C. Fana, W. Wehbeh, Carl M. Urban, Sorana Segal‐Maurer · 发表于：Clinical Infectious Diseases · 年份：2009 · DOI：10.1086/600039 · 被引用次数：154 · 研究领域：Antimicrobial Resistance in Staphylococcus、Infective Endocarditis Diagnosis and Management、Orthopedic Infections and Treatments

BACKGROUND: There are limited safety data for high-dose and long-term daptomycin treatment (16mg/kg administered for >or=14 days). We present our experience in 61 patients. METHODS: We performed a retrospective chart review for all patients treated with daptomycin at New York Hospital Queens (Flushing) from 1 January 2004 through 30 April 2007; patients were identified through a computerized hospital pharmacy database. RESULTS: Sixty-one patients (29 male and 32 female patients; mean age, 66.6 years) received a mean dose of 8 mg/kg of daptomycin for a median of 25 days (range, 14-82 days). Twelve patients (with bone and skin and softtissue infections) did not have an identified microbiologic isolate. Gram-positive infections included bloodstream infection with or without infective endocarditis (n = 32), skin and soft-tissue infection (n = 14), bone and joint infection (n = 9), and intra-abdominal infection (n = 5), and unidentified infection (n = 1). Prosthetic devices were removed from 11 of 20 patients. Grade 1 adverse events occurred in 22 patients and did not lead to daptomycin discontinuation. Fifty-eight patients underwent creatine phosphokinase (CPK) analysis (34 patients had paired CPK analyses at the beginning of and during therapy, and 13 patients had random CPK analysis performed during treatment). Three patients had constitutional and/or musculoskeletal symptoms accompanying CPK levels 110 times upper limit of normal (grade 3). All occurred after 24 days of treatm...