High-Dose Daptomycin for Device-Related Staphylococcal Endocarditis

Twenty of 25 patients with this condition were cured (median daily dose, 8.3 mg/kg); none required discontinuation or dose reduction of daptomycin because of adverse events.

The incidence of infections associated with cardiac implantable electronic devices (CIEDs) is increasing. Although removal of the entire pacing system is the cornerstone of management, appropriate antibiotic therapy is also crucial. Daptomycin is bactericidal against staphylococci and has good penetration into biofilms, suggesting that it may be useful for CIED-related infections. However, the recommended dose — 6 mg/kg daily — has performed no better than standard antimicrobial therapy. Might higher doses be more effective but equally safe?

To shed light on this issue, researchers in Naples, Italy, describe their experience using daptomycin at doses >6 mg/kg daily in 25 patients with CIED-associated staphylococcal endocarditis. On echocardi…

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)