Daptomycin与标准治疗菌血症,心内膜炎由金黄色葡萄球菌引起的。
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科里GR,福勒VG Jr,鲍彻HW Abrutyn E, Karchmer啊,拉普我,莱文DP,钱伯斯高频,统计FP, Vigliani GA,卡贝尔CH,链接,DeMeyer我,填料SG, Zervos M,库克P, Parsonnet J,伯恩斯坦JM,价格CS,福勒斯特GN, Fatkenheuer G, Gareca M,雷姆曾为此写过SJ, Brodt人力资源,泰斯•SE
Daptomycin与标准治疗菌血症,心内膜炎由金黄色葡萄球菌引起的。
郑传经地中海J。2006年8月17日,355 (7):653 - 65。
- PubMed ID
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16914701 (在PubMed]
- 文摘
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背景:替代治疗金黄色葡萄球菌菌血症及心内膜炎是非常必要的。方法:我们随机分配124金黄色葡萄球菌菌血症患者有或没有心内膜炎接收6毫克的daptomycin静脉注射每天每公斤体重,122年获得初始低剂量庆大霉素+一个antistaphylococcal青霉素或万古霉素。主要疗效终点是成功结束后42天的治疗。结果:42天治疗结束后在修改后的意向处理分析中,一个成功的结果是记录120年53病人daptomycin比48 115名患者接受标准治疗(44.2%比41.7%;绝对差异,2.4%;95%置信区间,-10.2至15.1%)。我们的结果符合指定标准daptomycin的非劣性。子组的成功率是类似的复杂的菌血症,患者右侧心内膜炎和耐甲氧西林金黄色葡萄球菌。Daptomycin疗法与较高的微生物学的失败比标准疗法(19和11个患者,P = 0.17)。微生物学的衰竭患者在6的19 daptomycin组隔离与敏感性降低daptomycin出现; similarly, a reduced susceptibility to vancomycin was noted in isolates from patients treated with vancomycin. As compared with daptomycin therapy, standard therapy was associated with a nonsignificantly higher rate of adverse events that led to treatment failure due to the discontinuation of therapy (17 vs. 8, P=0.06). Clinically significant renal dysfunction occurred in 11.0 percent of patients who received daptomycin and in 26.3 percent of patients who received standard therapy (P=0.004). CONCLUSIONS: Daptomycin (6 mg per kilogram daily) is not inferior to standard therapy for S. aureus bacteremia and right-sided endocarditis. (ClinicalTrials.gov number, NCT00093067 [ClinicalTrials.gov].).
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