Daptomycin Effective Against MRSA Skin Infections in Children


A multi-institution research team has found that daptomycin is effective and well-tolerated in children.

Methicillin-resistant Staphylococcus aureus (MRSA) continues to pose a problem for healthcare providers in that it has developed resistance to most available antibiotics, making it that much harder to treat. MRSA is notorious for causing skin infections, especially in children, and for these reasons, researchers everywhere have been frantically trying to find new ways to treat these infections.

Now, researchers from several institutions have come together to conduct a “first of its kind” randomized, controlled clinical trial that has shown that daptomycin, which had been approved for adults in the past, is also effective in children when it comes to the treatment of MRSA-causing skin and skin structure infections.

Although MRSA infections are commonly found in hospital settings and nursing homes, community-associated MRSA (CA-MRSA) infections are found in schools, daycare centers, and playgrounds, where children are in close contact with each other on a regular basis. Through the sharing of contaminated toys as well as through open scrapes or cuts, children can easily contract CA-MRSA infections, which, in addition to skin infections, can cause a variety of problems, such as pneumonia or bone/joint infections.

Knowing these facts about MRSA infections in children, the study researchers aimed to gauge safety and effectiveness of daptomycin to treat pediatric skin infections. As part of the study, the researchers enrolled 250 children between the ages of 1 and 17 and exposed them to the antibiotic. They measured their dosing based on “adult experience.”

The researchers found that when it comes to children, the younger that they were in age, the quicker their bodies worked to eliminate the antibiotic. “Thus pediatric doses increased as the age of the research participants decreased.”

First author John Bradley, MD, professor of clinical pediatrics, co-chief of the Division of Infectious Diseases at UC San Diego School of Medicine and director of the Division of Infectious Diseases at Rady’s Children Hospital-San Diego explained the findings in a recent press release.

“The safety and efficacy of intravenous daptomycin was comparable to standard-of-care IV antibiotics used for hospitalized children, usually vancomycin or clindamycin for MRSA and cefazolin for methicillin-susceptible strains of S. aureus.” He continued, “Daptomycin should provide a safe and effective alternative to vancomycin, clindamycin, or linezolid for IV treatment of invasive MRSA skin infections. Concerns for vancomycin renal toxicity and clindamycin antibiotic resistance were not present. There was no evidence of daptomycin toxicity in the trial.”

Currently, the use of daptomycin to treat pediatric skin infections is being reviewed by the US Food and Drug Administration.

In the meantime, the Centers for Disease Control and Prevention suggests practicing good hand hygiene, keeping any cuts or scrapes clean and covered, avoiding the sharing of any items “such as towels and razors,” and seeking care if a MRSA infection is suspected.

“Most news these days is about the declining utility of antibiotics as microbial resistance becomes more widespread and intractable. These findings are encouraging. Daptomycin appears to be a suitable, once-a-day alternative to existing antibiotics with harsher side effects,” Dr. Bradley concluded.

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