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Adverse Reactions to Antibiotics in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Diane M. Parente, Cheston B. Cunha, Michael Lorenzo
Quinupristin/dalfopristin can cause reversible musculoskeletal adverse reactions, including severe, protracted myalgias and rhabdomyolysis. Daptomycin can cause creatine kinase elevation and reversible myalgias. While the mechanism of daptomycin-induced myopathy is unknown, higher doses (>6 mg/kg) and concomitant use of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase (HMG-CoA) reductase inhibitors (statins) have been associated with increased risk [75–77]. Owing to the potential synergistic myopathic toxicity, evaluation of whether to hold statin therapy while on daptomycin may be considered. However, concurrent statin therapy should not hinder CCU practitioners from daptomycin use when clinically indicated for severe infections. Creatine kinase monitoring is recommended once weekly while on daptomycin, and it should be discontinued if the creatine kinase is greater than 1000 U/L in patients with symptoms of myopathy or greater than 2000 U/L in asymptomatic patients. Quinupristin/dalfopristin can cause severe, protracted arthralgias (9%) and myalgias (6%) typically with higher doses [78].
Daptomycin
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Anouk E. Muller, Inge C. Gyssens
The main clinical use of daptomycin is to treat infections caused by (resistant) Gram-positive microorganisms. The clinical efficacy of daptomycin has mainly been evaluated in major clinical trials in adult patients with cSSSI and S. aureus bacteremia, with or without endocarditis. An extensive postmarketing database, CORE, is available, which is a multicenter observational registry that involves 45 institutions and is designed to characterize infection types, pathogens, and outcomes of patients who were treated with daptomycin (Lamp et al., 2007; Levine and Lamp, 2007; Owens et al., 2007; Sakoulas et al., 2007; Forrest et al., 2008). Details on the methodology of the CORE registry are published, with data collected retrospectively by trained investigators to document real-world clinical experience. Study limitations include uncontrolled diagnostic criteria, some noncomparative data, and lack of followup assessments (Rolston et al., 2007).
Optimization of dosing regimens of vancomycin, teicoplanin, linezolid and daptomycin against methicillin-resistant Staphylococcus aureus in neutropenic patients with cancer by Monte Carlo simulations
Published in Journal of Chemotherapy, 2021
Xiaochen Wei, Mingfeng Zhao, Xia Xiao
Daptomycin is a cyclic lipopeptide antibiotic with rapid bactericidal activity against most clinically relevant Gram-positive pathogens, including many antibiotic-resistant strains. Considering its once-daily administration, short infusion time, and good safety profile, daptomycin can be suggested as a therapeutic option of interest in patients with neutropenia.4 According to the PK/PD analysis, the standard daptomycin dosage of 6 mg/kg/day was not enough to cover S.aureus with an MIC of 0.5 µg/mL for neutropenic cancer patients and higher doses should be considered in order to attain the target PTA. However, in the case of S.aureus at an MIC of 1 µg/mL, none of the simulated dosing regimens was effective for neutropenic cancer patients. Furthermore, CFR results showed the high-dose of at least 8 mg/kg/day was sufficient to treat MRSA infections in neutropenic patients with cancer. These results were similar to a previous report that 8-10 mg/kg dosing of daptomycin was likely necessary at the onset of treatment of MRSA infections in critically ill patients.10
Combatting resistant enterococcal infections: a pharmacotherapy review
Published in Expert Opinion on Pharmacotherapy, 2018
Nicholas J Mercuro, Susan L Davis, Marcus J Zervos, Erica S Herc
Clinical and in vitro data support aminopenicillin combinations for E. faecalis endocarditis [90]. A multicenter observational cohort described similar mortality in patients receiving ceftriaxone and ampicillin compared to patients who received ampicillin and gentamicin, despite patients in the ampicillin/ceftriaxone group having more comorbidities. Interruption in antibiotic treatment due to adverse effects was more common in the aminoglycoside group, mostly from renal failure [41]. These regimens may be applicable to other severe, complicated infections on a case-by-case basis [91]. An assessment of harm and benefit should be performed when selecting an adjuvant aminoglycoside vs. cephalosporin, in the absence of HLAR. While cephalosporins increase the risk of C. difficile, many patients will not tolerate aminoglycoside toxicities. To improve safety in high-risk populations, reducing aminoglycoside duration of therapy to two weeks and reducing frequency to once-daily dosing may attenuate nephrotoxicity [92]. If penicillin allergic, we strongly suggest obtaining an accurate allergy history and undergoing desensitization if necessary. If desensitization is not feasible, daptomycin in combination with a cephalosporin, aminoglycoside, or intravenous fosfomycin (when available) can be considered for complicated bloodstream infections (Figure 3). While guidelines recommend vancomycin with an aminoglycoside in these cases, patients are unlikely to tolerate the regimen for a long duration due to nephrotoxicity.
A cost minimisation analysis comparing oral linezolid and intravenous daptomycin administered via an outpatient parenteral antibiotic therapy programme in patients requiring prolonged antibiotic courses
Published in Journal of Chemotherapy, 2023
In terms of clinical evidence, only one study was found comparing daptomycin and linezolid directly in this area. It was however a retrospective analysis with a small number of patients. Treatment strategies were heterogenous with both implant retention and removal strategies. The study nonetheless found that the agents were equivalent in terms of infection control rates. This particular study did however find that there were significantly fewer adverse events in those treated with daptomycin. However it should be noted that patients in the linezolid group received up to 50 days of therapy which is considerably more than the licence allows for and the treatment course that we are considering in our analysis [47].