Is daptomycin plus ceftaroline associated with better clinical outcomes than standard of care monotherapy for staphylococcus aureus bacteremia?

Andre C. Kalil, Marisa Holubar, Stan Deresinski, Henry F. Chambers

Research output: Contribution to journalArticle

Abstract

Geriak and colleagues (1) evaluated the combination of daptomycin plus ceftaroline versus standard of care monotherapy for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. The investigators elected to terminate the trial early due to an “unanticipated in-hospital mortality difference favoring the combination therapy” (1). The randomization process failed to provide comparable treatment arms both in number (combination [intervention] n = 17; monotherapy [control] n = 23) and baseline clinical characteristics: the monotherapy group had a higher proportion of patients with diabetes, end-stage renal disease, immunocompromise, chronic lung disease, malignancy, and neutropenia, and more respiratory and intra-abdominal sites of infection (expected higher mortality than other sites). The monotherapy group had higher procalcitonin and C-reactive protein levels and lower platelet counts, markers of a more severe inflammatory state at baseline. All these comorbidities, sites of infection, and biomarker imbalances biased the results against the monotherapy group.

Original languageEnglish (US)
Article numbere00900-19
JournalAntimicrobial Agents and Chemotherapy
Volume63
Issue number11
DOIs
StatePublished - Jan 1 2019

Fingerprint

Daptomycin
Standard of Care
Bacteremia
Staphylococcus aureus
Intraabdominal Infections
Calcitonin
Methicillin-Resistant Staphylococcus aureus
Random Allocation
Hospital Mortality
Neutropenia
Platelet Count
C-Reactive Protein
Lung Diseases
Chronic Kidney Failure
Comorbidity
Chronic Disease
Therapeutics
Biomarkers
Research Personnel
Mortality

Keywords

  • Ceftaroline
  • Clinical outcomes
  • Daptomycin
  • Medical outcomes
  • Staphylococcus aureus
  • Vancomycin

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Is daptomycin plus ceftaroline associated with better clinical outcomes than standard of care monotherapy for staphylococcus aureus bacteremia? / Kalil, Andre C.; Holubar, Marisa; Deresinski, Stan; Chambers, Henry F.

In: Antimicrobial Agents and Chemotherapy, Vol. 63, No. 11, e00900-19, 01.01.2019.

Research output: Contribution to journalArticle

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