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Beta-lactam/daptomycin combo does not reduce mortality rates in patients with MSSA bacteremia

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January 21, 2019

The combination of a beta-lactam and daptomycin did not improve outcomes in patients with methicillin-susceptible Staphylococcus aureus, or MSSA, bacteremia compared with a beta-lactam alone, study findings showed.

S . aureus is one of the most significant causes of death from bloodstream infections, according to researchers. Increasing health care exposure and the use of invasive medical devices have increased the burden of the disease.

“The prompt administration of active antibiotic treatment within the first few days of infection has been associated with a decrease in complications linked to S. aureus bacteremia,” Sara Grillo, of the department of infectious disease at Bellvitge University Hospital and the Institut d’Investigacio Biomedica de Bellvitge in Barcelona, and colleagues wrote. “Despite straightforward evidence-based bundle interventions for MSSA bacteremia, doubts remain on the best antimicrobial therapy.”

According to the authors, previous studies have shown “possible beneficial effects” of daptomycin in combination with beta-lactams in the treatment of MSSA bacteremia. However, larger studies are lacking. Researchers aimed to determine the impact of the combination therapy vs. monotherapy through a retrospective cohort study at a tertiary hospital from January 2011 through December 2017.

Overall, 350 patients were included in the study, with 136 receiving the beta-lactam and daptomycin combination and 214 receiving a beta-lactam alone, according to researchers. Results of the study showed that patients who received the beta-lactam and daptomycin combination had higher Pitt scores, a test used to determine severity of the bacteremia, and they also experienced persistent bacteremia more often than patients in the beta-lactam-only group. Further analysis showed that there were no significant differences between the two groups of patients for all-cause mortality rates at 7, 30 and 90 days.

“The present study, which is the largest cohort study to date evaluating the usefulness of [beta-lactam and daptomycin combination] in clinical outcomes for MSSA bacteremia, found that daptomycin in combination with anti-staphylococcal beta-lactams had no effect on reducing mortality compared to beta-lactam monotherapy,” the authors concluded. – by Caitlyn Stulpin

Disclosures: The authors report no relevant financial disclosures.

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