With increasing antibiotic resistance reported worldwide, there is an urgent need for novel treatments for infections caused by Gram-positive bacteria. Daptomycin is the first in a new class of antibiotic, the cyclic lipopeptides, with activity against a range of Gram-positive pathogens. US approval of daptomycin for the treatment of complicated skin and soft-tissue infections (cSSTIs) caused by Gram-positive bacteria was gained in 2003, with European approval granted in January 2006. Most Gram-positive clinical isolates tested have proved susceptible to daptomycin, including methicillin- and vancomycin-resistant strains. Daptomycin has a novel mode of action, is rapidly bactericidal in vitro and has a low potential for the development of resistance. Two pivotal phase III studies, in a total of 1092 patients with cSSTIs, demonstrated non-inferiority to currently used antibiotics and a comparable tolerability profile. The unique mode of action of daptomycin is described alongside studies demonstrating its potential in the treatment of cSSTIs and other infections caused by Gram-positive bacteria.

No abstract

There is a lack of data on the predictive value of tuberculosis (TB) specific interferon-gamma release assays (TIGRAs) for both immunocompetent and immunocompromised individuals. We retrospectively followed up 460 such patients after QuantiFERON®-TB Gold In-Tube (QFT-GIT) testing (mean follow-up 28 months) by reviewing patient charts. A total of 1/38 QFT-GIT-positive and no QFT-GIT-negative patients developed active TB. The incidence rate of progression to active TB assessed retrospectively in these patients after positive TIGRA was therefore low (1.2 events/100 person-years). The need for careful follow-up and prophylactic therapy after positive TIGRA in this patient group needs to be evaluated prospectively.

Glycopeptide use differs considerably at tertiary care hospitals in southern Germany, but use of < 1.5 DDD/100 patient days in both surgical as well as medical tertiary care hospital departments appears achievable.

No abstract