Comparative Analysis of Daptomycin and Vancomycin in the Treatment of Vertebral Osteomyelitis

Rangaraj, Gopikishan; Cleveland, Kerry O.; Gelfand, Mikhail S.

doi:10.1097/ipc.0000000000000116

Cited by 13 publications

(11 citation statements)

References 15 publications

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“…Linezolid is recommended as an option for MRSA osteomyelitis, although the increasing risk of bone marrow suppression with prolonged courses of linezolid is a concern [8]. Recently, a retrospective analysis of 61 cases of MRSA vertebral osteomyelitis showed that patients treated with daptomycin had a higher cure rate than those treated with vancomycin (97% [30/31] vs 70% [21/30]; P = .006) [35].…”

Section: Discussionmentioning

confidence: 99%

Selection of an appropriate empiric antibiotic regimen in hematogenous vertebral osteomyelitis

et al. 2019

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BackgroundEmpiric antibiotic therapy for suspected hematogenous vertebral osteomyelitis (HVO) should be initiated immediately in seriously ill patients and may be required in those with negative microbiological results. The aim of this study was to inform the appropriate selection of empiric antibiotic regimens for the treatment of suspected HVO by analyzing antimicrobial susceptibility of isolated bacteria from microbiologically proven HVO.MethodWe conducted a retrospective chart review of adult patients with microbiologically proven HVO in five tertiary-care hospitals over a 7-year period. The appropriateness of empiric antibiotic regimens was assessed based on the antibiotic susceptibility profiles of isolated bacteria.ResultsIn total, 358 cases of microbiologically proven HVO were identified. The main causative pathogens identified were methicillin-susceptible Staphylococcus aureus (33.5%), followed by methicillin-resistant S. aureus (MRSA) (24.9%), Enterobacteriaceae (19.3%), and Streptococcus species (11.7%). Extended spectrum β-lactamase (ESBL)-producing Enterobacteriaceae and anaerobes accounted for only 1.7% and 1.4%, respectively, of the causative pathogens. Overall, 73.5% of isolated pathogens were susceptible to levofloxacin plus rifampicin, 71.2% to levofloxacin plus clindamycin, and 64.5% to amoxicillin-clavulanate plus ciprofloxacin. The susceptibility to these oral combinations was lower in cases of healthcare-associated HVO (52.6%, 49.6%, and 37.6%, respectively) than in cases of community-acquired HVO (85.8%, 84.0%, and 80.4%, respectively). Vancomycin combined with ciprofloxacin, ceftriaxone, ceftazidime, or cefepime was similarly appropriate (susceptibility rates of 93.0%, 94.1%, 95.8%, and 95.8%, respectively).ConclusionsBased on our susceptibility data, vancomycin combined with a broad-spectrum cephalosporin or fluoroquinolone may be appropriate for empiric treatment of HVO. Fluoroquinolone-based oral combinations may be not appropriate due to frequent resistance to these agents, especially in cases of healthcare-associated HVO.

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Section: Discussionmentioning

confidence: 99%

Selection of an appropriate empiric antibiotic regimen in hematogenous vertebral osteomyelitis

et al. 2019

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“…If surgical intervention is chosen an isolated decompression procedure leads up to 43 % reoperation rates [27]. Concomitant surgical stabilization is [28,36,[44][45][46]. The two studies focusing on immunosuppressed patients described that surgical treatment in HIV patients is not associated with more complications, while early hardware failure was more common in surgically treated IVDUs [33,47].…”

Section: Discussionmentioning

confidence: 99%

“…Rangaraj et al retrospectively analyzed the efficiency of vancomycin and Daptomycin in the treatment of MRSA spondylodiscitis [46]. The relapse rate in the Daptomycin groups was 3 %, whereas 30 % relapse was found in the vancomycin group [46] (Table 8).…”

Section: Microorganism-specific Treatmentmentioning

confidence: 99%

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Outcome of conservative and surgical treatment of pyogenic spondylodiscitis: a systematic literature review

et al. 2015

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Background Spondylodiscitis is a spinal infection affecting primarily the intervertebral disk and the adjacent vertebral bodies. Currently many aspects of the treatment of pyogenic spondylodiscitis are still a matter of debate. Purpose The aim of this study was to review the currently available literature systematically to determine the outcome of patients with pyogenic spondylodiscitis for conservative and surgical treatment strategies. Methods A systematic electronic search of MEDLINE, EMBASE, Cochrane Collaboration, and Web of Science regarding the treatment of pyogenic spondylodiscitis was performed. Included articles were assessed on risk of bias according the Cochrane Handbook for Systematic Reviews of Interventions, and the quality of evidence and strength of recommendation was evaluated according the GRADE approach. Results 25 studies were included. Five studies had a high or moderate quality of evidence. One RCT suggest that 6 weeks of antibiotic treatment of pyogenic spondylodiscitis results in a similar outcome when compared to longer treatment duration. However, microorganism-specific studies suggest that at least 8 weeks of treatment is required for S. aureus and 8 weeks of Daptomycin for MRSA. The articles that described the outcome of surgical treatment strategies show that a large variety of surgical techniques can successfully treat spondylodiscitis. No additional long-term beneficial effect of surgical treatment could be shown in the studies comparing surgical versus antibiotic only treatment. Conclusion There is a strong level of recommendation for 6 weeks of antibiotic treatment in pyogenic spondylodiscitis although this has only been shown by one recent RCT. If surgical treatment is indicated, it has been suggested by two prospective studies with strong level of recommendation that an isolated anterior approach could result in a better clinical outcome.

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“…На основании данного анализа был сделан вывод, что даптомицин может стать одним из препаратов выбора для терапии остеомиелита, но для этого необходимо проведение дополнительных проспективных исследований. Похожий анализ был проведен в отношении септического артрита, в результате также были сделаны выводы о потенциальной возможности применения даптомицина по этому показанию [9,10].…”

Section: применение даптомицина в клинической практикеunclassified

Daptomycin: possibilities and prospectives of administration in clinical practice

Danilov

Игоревич²,

Евсеев

et al. 2020

Rev Clin Pharm Drug Ther

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Daptomycin is the first representative of the class of cyclic polypeptides, reached the application in clinical practice. Unlike most antibiotics, it has rapid bactericidal activity, including against microbial cells in biofilms. The spectrum of activity of daptomycin includes almost all clinically significant gram(+) bacteria, including strains resistant to other classes of antimicrobials. Currently, in the Russian Federation, daptomycin is registered for two indications: complicated skin and soft tissue infections at a dose of 4 mg/kg 1 time per day and blood flow infections caused by S. aureus, including bacteremia and right-sided endocarditis, at a dose of 6 mg/kg 1 time per day.

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Comparative Analysis of Daptomycin and Vancomycin in the Treatment of Vertebral Osteomyelitis

Cited by 13 publications

References 15 publications

Selection of an appropriate empiric antibiotic regimen in hematogenous vertebral osteomyelitis

Selection of an appropriate empiric antibiotic regimen in hematogenous vertebral osteomyelitis

Outcome of conservative and surgical treatment of pyogenic spondylodiscitis: a systematic literature review

Daptomycin: possibilities and prospectives of administration in clinical practice

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