Is daptomycin effective for both right-sided and left-sided bacterial endocarditis?

Fowler VG, et al. Daptomycin versus standard therapy for bacteremia and endocarditis caused by
Staphylococcus aureus. N Engl J Med. 2006 Aug 17;355(7):653-65.

Not enough data on left-sided endocarditis.  Data for right-sided endocarditis suggests that daptomycin is as effective as gentomycin plus penicillin/vancomycin.

In this open label study patients with S. aureus bacteremia with or without endocarditis were randomized to receive 6 mg of daptomycin per kg body weight daily (n=124, 19 with right-sided encarditis) or initial low-dose gentamicin plus either an antistaphylococcal penicillin or vancomycin (n=122, 16 with right-sided encarditis).  Group of ID physicians, blinded to allocation, determined diagnosis based on Duke Criteria.  Small number of patients with left-sided endocarditis included (9 in each arm) prior to an amendment excluding patients with left-sided endocarditis.

Figure 1 compares outcomes for the two arms in various subgroups, including right-sided and left-sided encarditis.


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Clinical Informationist at EUH Branch Library
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