Session : Hot Clinical Trials

117 - Adjunctive Daptomycin in the Treatment of staphylococcus Aureus Bacteremia

Oral Abstract

Location: On Demand

Background: Bloodstream infections (BSI) caused by methicillin-susceptible Staphylococcus aureus (MSSA) are associated with significant morbidity and mortality. The objective of our study was to determine whether daptomycin given in combination with an anti-staphylococcal beta-lactam improved outcomes in MSSA BSI.

Methods: A randomized, double blind, placebo-controlled trial was performed at two academic hospitals in Montreal, Canada. Patients ≥ 18 years of age with MSSA BSI receiving either cefazolin or cloxacillin monotherapy were considered for inclusion. In addition to the standard of care treatment, participants received a 5-day course of adjunctive daptomycin or placebo. The primary outcome was the duration of MSSA BSI in days.

Results: Of 318 participants screened, 115 were enrolled and 104 were included in the intention to treat analysis (median age 67 years; 34.5% female). The median duration of bacteremia was 2.04 days among patients who received daptomycin versus 1.65 days in those who received placebo (absolute difference 0.39 days, p=0.40). A modified intention to treat analysis involving participants who remained bacteremic at the time of enrollment found a median duration of bacteremia of 3.06 days among patients who received daptomycin versus 3.0 days in those who received placebo (absolute difference 0.06 days, p=0.77). Ninety-day mortality in the daptomycin arm was 18.9% vs. 17.7% in the placebo arm (p=1.0). There were no significant differences in the proportion of patients who developed renal failure, hepatotoxicity, or rhabdomyolysis between groups.

Conclusion: Among patients with MSSA BSI, the administration of adjunctive daptomycin therapy to standard of care treatment did not shorten the duration of bacteremia.

Presenting Author(s)

Matthew P. Cheng, MD

Assistant Professor
McGill University Health Center
Montreal, QC, Canada

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Slides Slides and Audio

Co-Author(s)

Alexander Lawandi, MD

Fellow
Department of Critical Care Medicine, National Institutes of Health Clinical Center
Bethesda, Maryland

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
GB

Guillaume Butler-Laporte, MD

Fellow
McGill University Health Centre
Montreal, Quebec, Canada

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SD

Samuel De L'Etoile-Morel, MD

Fellow
McGill University Health Centre
Montreal, Quebec, Canada

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
KP

Katryn Paquette, M.D.

Assistant Professor
Department of Pediatrics, McGill University Health Center, Montreal, Canada
Montreal, Quebec, Canada

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
TL

Todd C. Lee, MD, MPH

Associate Professor of Medicine
McGill University
Montreal, Quebec, Canada

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.