Higher Doses of Daptomycin for Vancomycin-Resistant Enterococcal Bacteremia

In a large retrospective study, doses of ≥10 mg/kg/day versus standard 6 mg/kg/day resulted in lower mortality with no increase in toxicity.

Vancomycin-resistant enterococcal (VRE) bloodstream infections present treatment challenges. Studies have suggested that outcomes are improved with linezolid versus daptomycin, but this finding may have been due to suboptimal dosing of daptomycin. Whereas 6 mg/kg/day of daptomycin is recommended for Staphylococcus aureus infections, higher doses may be required for successful therapy of VRE infections.

To test this hypothesis, investigators performed a retrospective cohort study of 911 patients with VRE bacteremia who were treated with daptomycin at 81 Veterans Affairs hospitals between 2004 and 2014. Patients were stratified by daptomycin dose: 78% received standard-dose therapy (6 mg/kg/day), 16% received medium-dose therapy (8 mg/kg/day),…

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)

Higher Doses of Daptomycin for Vancomycin-Resistant Enterococcal Bacteremia

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Reviewing Author