A critical view on the current use of daptomycin in Spain: The daptomise study
Por:
Gonzalez, CGR, de Vega, EC, Martinez, SD, Minero, MV, Urbon, JMG, Manzorro, AG, Martinez, EFD, Sacristan, SC, Santiago, EB, Alonso, AH, de Paredes, PMG, Saez, MS
Publicada:
1 jul 2023
Ahead of Print:
1 may 2023
Resumen:
Background: The Study on the Clinical Use of DAPTOMycin in Spain (DAPTOMISE Study) is a national surveillance program of daptomycin use. The objectives of this study are to evaluate the current variability in daptomycin consumption across the different hospitals and the adequacy of therapy, specially focused on underdosing. Methods: All adult and pediatric patients who received, at least, one dose of daptomycin in a single week in 98 institutions in Spain were included. The adequacy of daptomycin use was evaluated with respect to the indication, dosage, adjustments after microbiology results, switching to an oral agent and length of treatment. Results: A total of 615 patients received daptomycin during the study week. The prevalence use was 2.3 patients / 100,000 inhabitants per week, 12.4 patients / 1000 admissions and 9.2 Days of Therapy (DOT) / 1000 hospital stays. These rates varied between hospitals: from 0 to 13.9 patients / 100,000 inhabitants, from 0 to 76.1 patients / 1000 admissions and from 0 to 49.4 DOT / 1000 hospital stays. The most frequent infections were bacteremia (31.6 %) and skin and soft tissue infections (17.9 %). Microbiological results were available in only 65.4 % of infections. The most frequent microorganisms were Staphylococcus aureus (192 isolates, of which 87 were resistant to methicillin) and coagulase-negative staphylococci (124 isolates). A total of 136 prescriptions (22.1 %) were underdosed. Dosages < 8 mg/kg were used for 35.6 % of endovascular infections and for 26.2 % of osteoarticular infections. Overall, 57.2 % of prescriptions were not optimal in, at least, one item. Clinical cure rate was 76.1% and mortality attributable to the infection 8.1%. Conclusion: This is the first registry that identifies the prevalence of use of daptomycin in Spain and shows a high variability in the consumption between the different hospitals. Daptomycin underdosing was present in more than 20 % of cases. (c) 2023 Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Filiaciones:
Gonzalez, CGR:
Hosp Gen Univ Gregorio Maranon, Pharm Dept, Doctor Esquerdo 46, Madrid 28007, Spain
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
de Vega, EC:
Hosp Gen Univ Gregorio Maranon, Pharm Dept, Doctor Esquerdo 46, Madrid 28007, Spain
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
Martinez, SD:
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
Hosp Gen Univ Gregorio Maranon, Clin Microbiol & Infect Dis Dept, Madrid, Spain
Minero, MV:
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
Hosp Gen Univ Gregorio Maranon, Clin Microbiol & Infect Dis Dept, Madrid, Spain
Univ Complutense Madrid, Sch Med, Med Dept, Madrid, Spain
Urbon, JMG:
Complexo Hosp Univ A Coruna, Pharm Dept, La Coruna, Spain
Manzorro, AG:
Hosp Gen Univ Gregorio Maranon, Pharm Dept, Doctor Esquerdo 46, Madrid 28007, Spain
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
Martinez, EFD:
Hosp Santa Creu & Sant Pau, Pharm Dept, Barcelona, Spain
Sacristan, SC:
Hosp Univ Bellvitge, Pharm Dept, IDIBELL, Barcelona, Spain
Santiago, EB:
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
Univ Complutense Madrid, Sch Med, Med Dept, Madrid, Spain
CIBER Enfermedades Resp, CIBERES CB06 06 0058, Madrid, Spain
Alonso, AH:
Hosp Gen Univ Gregorio Maranon, Pharm Dept, Doctor Esquerdo 46, Madrid 28007, Spain
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
de Paredes, PMG:
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
Hosp Gen Univ Gregorio Maranon, Clin Microbiol & Infect Dis Dept, Madrid, Spain
Univ Complutense Madrid, Sch Med, Med Dept, Madrid, Spain
CIBER Enfermedades Resp, CIBERES CB06 06 0058, Madrid, Spain
Saez, MS:
Hosp Gen Univ Gregorio Maranon, Pharm Dept, Doctor Esquerdo 46, Madrid 28007, Spain
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
gold, All Open Access; Gold
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