Daptomycin plus fosfomycin versus daptomycin alone for methicillin-resistant staphylococcus aureus bacteremia and endocarditis: a randomized clinical trial

dc.contributor.authorPujol, Miquel
dc.contributor.authorMiró, José María
dc.contributor.authorShaw, Evelyn
dc.contributor.authorAguado, Jose María
dc.contributor.authorSan Juan, Rafael
dc.contributor.authorPuig Asensio, Mireia
dc.contributor.authorPigrau, Carles
dc.contributor.authorCalbo Sebastian, Esther
dc.contributor.authorMontejo, Miguel
dc.contributor.authorRodríguez Álvarez, Regino
dc.contributor.authorGarcía Pais, María Jose
dc.contributor.authorPintado, Vicente
dc.contributor.authorEscudero Sánchez, Rosa
dc.contributor.authorLópez Contreras, Joaquín
dc.contributor.authorMorata, Laura
dc.contributor.authorMontero, Milagros
dc.contributor.authorAndrés, Marta
dc.contributor.authorPasquau, Juan
dc.contributor.authorArenas, María del Mar
dc.contributor.authorPadilla, Belén
dc.contributor.authorMurillas, Javier
dc.contributor.authorJover, Alfredo
dc.contributor.authorLópez Cortes, Luis Eduardo
dc.contributor.authorGarcía Pardo, Graciano
dc.contributor.authorGasch, Oriol
dc.contributor.authorVidela, Sebastian
dc.contributor.authorHereu, Pilar
dc.contributor.authorTebé, Cristian
dc.contributor.authorPallarès, Natalia
dc.contributor.authorSanllorente, Mireia
dc.contributor.authorDomínguez, María Ángeles
dc.contributor.authorCàmara, Jordi
dc.contributor.authorFerrer, Anna
dc.contributor.authorPadullés, Ariadna
dc.contributor.authorCuervo, Guillermo
dc.contributor.authorCarratalà, Jordi
dc.date.accessioned2022-02-14T12:05:46Z
dc.date.available2022-02-14T12:05:46Z
dc.date.issued2021
dc.description.abstractBackground. We aimed to determine whether daptomycin plus fosfomycin provides higher treatment success than daptomycin alone for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and endocarditis.Methods. A randomized (1:1) phase 3 superiority, open-label, and parallel group clinical trial of adult inpatients with MRSA bacteremia was conducted at 18 Spanish hospitals. Patients were randomly assigned to receive either 10 mg/kg of daptomycin intra-venously daily plus 2 g of fosfomycin intravenously every 6 hours, or 10 mg/kg of daptomycin intravenously daily. Primary endpoint was treatment success 6 weeks after the end of therapy.Results. Of 167 patients randomized, 155 completed the trial and were assessed for the primary endpoint. Treatment success at 6 weeks after the end of therapy was achieved in 40 of 74 patients who received daptomycin plus fosfomycin and in 34 of 81 patients who were given daptomycin alone (54.1% vs 42.0%; relative risk, 1.29 [95% confidence interval, .93–1.8]; P = .135). At 6 weeks, daptomycin plus fosfomycin was associated with lower microbiologic failure (0 vs 9 patients; P = .003) and lower complicated bac-teremia (16.2% vs 32.1%; P = .022). Adverse events leading to treatment discontinuation occurred in 13 of 74 patients (17.6%) re-ceiving daptomycin plus fosfomycin, and in 4 of 81 patients (4.9%) receiving daptomycin alone (P = .018).Conclusions. Daptomycin plus fosfomycin provided 12% higher rate of treatment success than daptomycin alone, but this dif-ference did not reach statistical significance. This antibiotic combination prevented microbiological failure and complicated bacte-remia, but it was more often associated with adverse eventsca_ES
dc.description.sponsorshipThis work was supported by the Spanish Ministry of Science, Innovation and Universities (PI12/01907); Spanish Network for Research in Infectious Diseases (RD16/0016/0005); Instituto de Salud Carlos III (ISCIII); and Spanish Ministry of Economy, Industry and Competitiveness. This work was also supported by the European Development Regional Fund “A way to achieve Europe,” Operational Programme Intelligent Growth 2014–2020; Spanish Clinical Research Network (SCReN), co-financed by the Plan Nacional de I+D and ISCIII, Subdirección General de Evaluación y Fomento de la Investigación (PT13/0002/0007); and the Grupo de Estudio de la Infección Relacionada con la Asistencia Sanitaria. J. M.-M. received a personal 80:20 research grant from the Institut d’Investigacions Biomèdiques Agust Pi i Sunyer, Barcelona, Spain, during 2017–2021.
dc.identifier.doihttps://doi.org/10.1093/cid/ciaa1081
dc.identifier.issn1058-4838
dc.identifier.issn1537-6591
dc.identifier.urihttp://hdl.handle.net/10459.1/73000
dc.language.isoengca_ES
dc.publisherOxford University Pressca_ES
dc.publisherInfectious Diseases Society of Americaca_ES
dc.relation.isformatofReproducció del document publicat a: https://doi.org/10.1093/cid/ciaa1081ca_ES
dc.relation.ispartofClinical Infectious Diseases, 2021, vol. 72, núm. 9, p. 1517-1525ca_ES
dc.rightscc-by-nc-nd (c) authors, 2020ca_ES
dc.rights.accessRightsinfo:eu-repo/semantics/openAccessca_ES
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectMRSAca_ES
dc.subjectBacteremiaca_ES
dc.subjectDaptomycinca_ES
dc.subjectFosfomycinca_ES
dc.subjectClinical trialca_ES
dc.titleDaptomycin plus fosfomycin versus daptomycin alone for methicillin-resistant staphylococcus aureus bacteremia and endocarditis: a randomized clinical trialca_ES
dc.typeinfo:eu-repo/semantics/articleca_ES
dc.type.versioninfo:eu-repo/semantics/publishedVersionca_ES
Files
Original bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
ClinicalInfectiousDiseases_a2021v72.pdf
Size:
784.17 KB
Format:
Adobe Portable Document Format
Description:
License bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description: