Daptomycin-based aminoglycoside-sparing therapy for streptococcal endocarditis: a retrospective multicenter study

Abstract

Streptococci still represent common etiologic agents of infective endocarditis (IE). Although renal failure is frequently reported as an aminoglycoside-associated adverse event, last international guidelines recommend a beta-lactam/gentamicin combination therapy. We retrospectively evaluated the use of daptomycin-based aminoglycoside-sparing combination therapy for the treatment of streptococcal IE in seven referral hospitals in Italy. Retrospective, multicenter, observational study. All patients with streptococcal IE admitted from 2016 to 2018 were enrolled. Mortality and incidence of acute kidney injury (AKI) were compared between Group A (standard of care, SoC) and Group B (daptomycin-based aminoglycoside-sparing combination therapy). Fifty-four patients were enrolled, 33 in Group A and 21 in Group B. Mortality was 2/33 (6%) in Group A and 0 in Group B (p = 0.681); AKI incidence was 8/33 (24%) in Group A and 0 in Group B (p = 0.04). Daptomycin-based aminoglycoside-sparing combination therapy appears to be promising for the treatment of streptococcal endocarditis because of similar efficacy compared with SoC and significantly reduced incidence of AKI.

Keywords:

• Aminoglycoside-sparing therapy
• Acute kidney injury
• Daptomycin
• Streptococcal endocarditis
• endocarditis

Disclosures

CT has received funds for speaking at symposia organized on behalf of Pfizer, Novartis, Merck, Angelini, Zambon, Thermofischer, Biotest, Gilead, Hikma, Biomerieux and Astellas. CP has received funds for speaking at symposia on behalf of Zambon, Angelini, Merck. SC has been speaker for Correvio and has served on advisory board for Angelini. FGDR has been speaker and member of advisory board for Pfizer, Correvio, MSD. No conflict of interest for the other authors.

Consent to participate

All the patients provided their consent to participate in retrospective observational study.

Consent to publication

All the authors approved the manuscript and its submission.

Availability of data

Data will be available after appropriate request.

Additional information

Notes on contributors

Carlo Pallotto

Carlo Pallotto, PhD, infectious diseases specialist; main field of interest are bacterial infections especially endocarditis, antimicrobial resistance, antimicrobial stewardship.

Francesco Sbrana

Francesco Sbrana, MD at the Fondazione Toscana Gabriele Monasterio, expert in cardiovascular diseases and infective complications.

Andrea Ripoli

Andrea Ripoli, bioingeneer and expert in biostatistics.

Tommaso Lupia

Tommaso Lupia, resident in Infectious Diseases, University of Turin; main field of interests are bacterial infections and infections in burn patients.

Silvia Corcione

Silvia Corcione, PhD, University of Turin; expert in the field of bacterial infections, antimicrobial resistance and antimicrobial stewardship.

Francesco Paciosi

Francesco Paciosi, resident in Infectious Diseases, University of Perugia; main field of interest are bacterial infections especially endocarditis.

Daniela Francisci

Daniela Francisci, professor of Infectious Diseases, University of Perugia and director of the Infectiuos Diseases Clinica of Perugia; expert in bacterial infections, HIV and viral hepatitis.

Maria Bruna Pasticci

Maria Bruna Pasticci, professor of Infectious Diseases, University of Perugia, expert of bacterial infections, tuberculosis and fungal infections.

Emanuela Sozio

Emanuela Sozio, emergency medicine specialist; main field of interest are bacterial infections especally endocaditis and meningitis.

Giacomo Bertolino

Giacomo Bertolino, expert in the field of antimicrobials.

Novella Carannante

Novella Carannante, Infectious Diseases specialist, expert in infective emergencies especially meningitis, bacterial infections and endocarditis.

Carolina Rescigno

Carolina Rescigno, director of the First Division of Infectious Diseases, Cotugno Hospital, expert in bacterial infections especially meningitis.

Antonio Carozza

Antonio Carozza, crdiosurgeon at the Monaldi Hospital, expert in the surgical treatment of infective endocarditis.

Giovanni Di Caprio

Giovanni Di Caprio, infeciotus diseases specialist, main field of interest are bacterial infections, antimicrobial resistance, antimicrobial stewardship.

Eleonora Taddei

Eleonora Taddei, resident in Infectious Diseases at Università Cattolica del Sacro Cuore, main field of interest are bacterial infections and antimicrobial resistance.

Rita Murri

Rita Murri, professor of infectious diseases at Università Cattolica del Sacro Cuore, expert in the field of bacterial infections, antimicrobial resistance and antimicrobial stewardship.

Massimo Fantoni

Massimo Fantoni, professor of infectious diseases at Università Cattolica del Sacro Cuore, expert in the field of bacterial infections, antimicrobial resistance and antimicrobial stewardship.

Michele Emdin

Michele Emdin, professor of cardiology and expert of infective endocarditis.

Alberto Aimo

Alberto Aimo, expert in cardiovascular diseases and especially infective endocarditis.

Francesco Giuseppe De Rosa

Francesco Giuseppe De Rosa, professor of infectious Diseases, University of Turin, expert in bacterial infections, antimicrobial resistance, antimicrobial stewardship and ew antimicrobials.

Carlo Tascini

Carlo Tascini, professor of infectious Diseases, University of Udine, expert in bacterial infections, antimicrobial resistance, antimicrobial stewardship and ew antimicrobials.