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Real-world daptomycin use across wide geographical regions: results from a pooled analysis of CORE and EU-CORE

机译:现实世界中达托霉素的使用范围广泛:对CORE和EU-CORE的汇总分析结果

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Background Pooled data from two large registries, Cubicin? Outcomes Registry and Experience (CORE; USA) and European Cubicin? Outcomes Registry and Experience (EU-CORE; Europe, Latin America, and Asia), were analyzed to determine the characteristics and clinical outcomes of daptomycin therapy in patients with Gram-positive infections across wide geographical regions. Methods Patients receiving at least one dose of daptomycin between 2004 and 2012 for the treatment of Gram-positive infections were included. Clinical success was defined as an outcome of ‘cured’ or ‘improved’. Post-treatment follow-up data were collected for a subset of patients (CORE: osteomyelitis and orthopedic foreign body device infection; EU-CORE: endocarditis, intracardiac/intravascular device infection, osteomyelitis, and orthopedic device infection). Safety was assessed for up to 30?days after daptomycin treatment. Results In 11,557 patients (CORE, 5482; EU-CORE, 6075) treated with daptomycin (median age, 62 [range, 1–103] years), the most frequent underlying conditions were cardiovascular disease (54.7?%) and diabetes mellitus (28.0?%). The most commonly treated primary infections were complicated skin and soft tissue infection (cSSTI; 31.2?%) and bacteremia (21.8?%). The overall clinical success rate was 77.2?% (uncomplicated SSTI, 88.3?%; cSSTI, 81.0?%; osteomyelitis, 77.7?%; foreign body/prosthetic infection (FBPI), 75.9?%; endocarditis, 75.4?%; and bacteremia, 69.5?%). The clinical success rate was 79.1?% in patients with Staphylococcus aureus infections (MRSA, 78.1?%). An increasing trend of high-dose daptomycin (>6?mg/kg/day) prescribing pattern was observed over time. Clinical success rates were higher with high-dose daptomycin treatment for endocarditis and FBPI. Adverse events (AEs) and serious AEs possibly related to daptomycin therapy were reported in 628 (5.4?%) and 133 (1.2?%) patients, respectively. Conclusions The real-world data showed that daptomycin was effective and safe in the treatment of various Gram-positive infections, including those caused by resistant pathogens, across wide geographical regions.
机译:背景来自两个大型注册管理机构Cubicin ?结果注册管理机构和经验(美国)和欧洲Cubicin ?结果注册管理机构和经验(欧盟的核心;欧洲,拉丁美洲)的汇总数据,以及亚洲)进行分析,以确定在广泛地理区域内对达克霉素治疗的革兰氏阳性感染患者的特征和临床疗效。方法纳入2004年至2012年间接受至少一剂达托霉素治疗革兰氏阳性感染的患者。临床成功被定义为“治愈”或“改善”的结果。收集了一部分患者的治疗后随访数据(CORE:骨髓炎和骨科异物器械感染; EU-CORE:心内膜炎,心内/血管内器械感染,骨髓炎和骨科器械感染)。达托霉素治疗后长达30天评估安全性。结果在接受达托霉素治疗的11,557名患者(CORE,5482; EU-CORE,6075)(中位年龄为62 [范围,1–103]岁)中,最常见的基础疾病是心血管疾病(54.7%)和糖尿病( 28.0%)。最常用的原发感染是复杂的皮肤和软组织感染(cSSTI; 31.2%)和菌血症(21.8%)。总体临床成功率为77.2%(单纯性SSTI为88.3%; cSSTI为81.0%;骨髓炎为77.7%;异物/修复感染(FBPI)为75.9%;心内膜炎为75.4%;菌血症,占69.5%)。金黄色葡萄球菌感染患者的临床成功率为79.1%(MRSA,78.1%)。随着时间的推移,观察到大剂量达托霉素(> 6?mg / kg /天)处方模式的增加趋势。大剂量达托霉素治疗心内膜炎和FBPI的临床成功率更高。分别报道了628例(5.4%)和133例(1.2%)的不良事件(AE)和可能与达托霉素治疗有关的严重AE。结论现实世界的数据表明,达托霉素在广泛的地理区域内可有效且安全地治疗各种革兰氏阳性感染,包括由耐药菌引起的感染。

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