A retrospective study of outcomes of device-associated osteomyelitis treated with daptomycin

Abstract

BackgroundDaptomycin appears well tolerated and effective for osteomyelitis treatment. However, limited data exist regarding daptomycin use for treatment of device-associated osteomyelitis (DAO).MethodsWe used a retrospective, observational database (Cubicin® Outcomes Registry and Experience [CORE® 2007–2009]) that assessed patients treated with daptomycin to evaluate the characteristics of patients with DAO, outcomes after daptomycin treatment, and safety of daptomycin in this setting. Information from 54 institutions for patients with prosthetic joint infection (PJI) and other hardware-associated osteomyelitis (OHAO) who received daptomycin from January 2007 to December 2008 with follow-up data in 2009 was collected using a standardized data collection form.ResultsEighty-two patients receiving daptomycin were identified in CORE 2007–2009; 48 patients (59 %) had follow-up data. Sixty-seven percent of patients had received a previous antibiotic. Surgical intervention was similar between the 2 groups: PJI, 22 of 27 (82 %) and OHAO, 17 of 21 (81 %). However, device removal or replacement was more frequent in the PJI patients (17 of 27, 63 %) than in the OHAO patients (8 of 21, 38 %). Clinical success was reported in 22 of 27 (82 %; 95 % confidence interval [CI], 62–94 %) patients with PJI and 18 of 21 (86 %; 95 % CI, 64–97 %) patients with OHAO at follow-up (13–402 days). Adverse events occurred in 8 of 50 (16 %) patients in the safety population and did not differ by daptomycin dose.ConclusionDaptomycin appeared effective and well tolerated in patients with DAO, including PJI or OHAO.

Real-World Clinical Use and Outcomes of Telavancin for the Treatment of Bone and Joint Infections: Results from the Telavancin Observational Use Registry (TOUR™)

“…Recent data on the treatment of bone and joint infections come largely from retrospective and/or observational studies such as TOUR. The retrospective, observational Cubicin ® Outcomes Registry and Experience (CORE ® ) study in the USA identified 82 patients with device-associated osteomyelitis treated with daptomycin, of whom 48 had available follow-up information; 22/27 (82%) of patients with prosthetic joint infection and 18/21 (86%) patients with other hardware-associated osteomyelitis had a cure or improvement with daptomycin treatment [27]. Patients with osteomyelitis and orthopedic device infections in a retrospective European registry (EU-CORESM) were cured or improved after daptomycin treatment in 522/638 (81.8%) cases [28].…”

Activities of Combinations of Antistaphylococcal Antibiotics with Fusidic Acid against Staphylococcal Biofilms in In Vitro Static and Dynamic Models

“…Taking these limitations into account, our work nonetheless demonstrates that combining fusidic acid with linezolid or daptomycin could be a useful therapeutic option against staphylococcal biofilm-related infections in areas and/or situations where resistance to these drugs is low (essentially, in North America [19][20][21], but not in Europe [50,51] or other regions of the world [52,53]). Linezolid and daptomycin, although recommended for short-term use, sometimes need to be use for long periods of time (Ͼ3 weeks [54][55][56][57]) in difficult situations, such as those involving biofilms, which may expose the patients to higher risks of adverse events. Synergic combinations, as those evidenced here with fusidic acid, may offer a real opportunity in this context.…”

Topical rifampin powder for orthopedic trauma part I: Rifampin powder reduces recalcitrant infection in a delayed treatment musculoskeletal trauma model

“…This project compared vancomycin powder to both daptomycin and rifampin powders. Daptomycin, a cyclic lipopeptide, maintains in vitro efficacy against most clinically relevant gram‐positive pathogens and is effective in patients with prosthetic joint or other orthopedic device infections when delivered systemically . This study, however, concluded that there is a lack of bacteria reduction when vancomycin or daptomycin powder was solely placed directly into the wound of a mature biofilm model.…”