Daptomycin for MRSA Bacteremia with a Borderline-High Vancomycin MIC?

In a retrospective study, 60-day mortality was significantly lower among patients who received daptomycin than among those who received vancomycin.

Vancomycin is the mainstay of therapy for methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSIs). Although some have suggested the use of alternative therapies when the vancomycin minimum inhibitory concentration (MIC) is elevated but still below the susceptibility breakpoint of 2 µg/mL, data supporting this recommendation are sparse.

To explore this issue, researchers conducted a retrospective case-control study comparing the effectiveness of vancomycin and daptomycin in patients who had MRSA BSIs with vancomycin MICs of 1.5 or 2.0 µg/mL. All participants were treated at a single Detroit medical center between 2005 and 2009. The study was funded by the manufacturer of daptomycin.

Among 177 participants, 59 received …

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)