Adding Beta-lactam to daptomycin improves MRSA clinical outcomes

Published On 2019-08-18 13:58 GMT   |   Update On 2019-08-18 13:58 GMT

USA: Adding beta-lactam (BL) antibiotic to daptomycin (DAP) improves clinical outcomes in patients with methicillin resistant Staphylococcus aureus bloodstream infections (MRSA BSIs), suggests a recent study.


Findings of the study, published in the journal Clinical Infectious Diseases, adds to the growing body of evidence that -- beta-lactam (BL) being ineffective on its own, enhances the action of daptomycin (DAP) through resulting synergistic in vitro activity against MRSA and bolstering the innate immune response to the infection.


MRSA is an ongoing public health problem, causing more than 80,000 infections and more than 11,000 deaths annually in the United States. In adults, MRSA infections that reach the bloodstream are responsible for numerous complications and fatalities, killing 10 per cent to 30 per cent of patients.





The retrospective, comparative cohort study was conducted at two academic medical centres in Detroit from 2008 through 2018 consisting of 229 patients. The researchers compared two groups of adults having MRSA BSIs' one group received DAP+BL (n=72), and the other group received daptomycin monotherapy (n=157).


The primary outcome was a composite clinical failure (60-day all-cause mortality and/or 60-day recurrence).


Also Read: Ticagrelor shows antimicrobial activity against MRSA, superior to vancomycin: JAMA


Key findings include:


  • In unadjusted and inverse probability of treatment weighted (IPTW)-adjusted analyses, DAP+BL was associated with significantly reduced odds of clinical failure (odds ratio [OR], 0.362; 95% confidence interval [CI], 0.164 to 0.801; adjusted OR, 0.386; 95% CI, 0.175 to 0.853).

  • Lower clinical failure was also consistently demonstrated in all pre-specified subgroups across the spectrum of host and infection characteristics.


Also Read: Patients allergic to penicillin at higher risk of C. difficile and MRSA infections : BMJ


"This study provides support to ongoing and future studies evaluating the impact of combination therapy for invasive MRSA infections," concluded the authors.




To read the complete study log on to https://doi.org/10.1093/cid/ciz746



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