Evaluating the Efficacy of Daptomycin and Ceftaroline for the Treatment of MRSAB

Rates of in-hospital mortality and days with bacteremia were similar between the two study cohorts.

Methicillin-resistant Staphylococcus aureus bacteremia (MRSAB) is a more severe form of an MRSA infection. Most cases of the infection develop secondary to another site of infection, however around 25% of cases have no initial site of infection identified.

MRSAB is most often associated with complications which result in a high rate of morbidity and mortality. The infection is often resistant to first-line therapy and there is currently no consensus on the preferred course of treatment for persistent MRSAB.

Recent data has suggested that a combination of daptomycin (DAP) and ceftaroline (CPT) may have the potential to successfully clear persistent MRSAB, however, the optimal use of the combination remains unclear.

Recently, investigators from the University of Alabama, Birmingham, have conducted a study to evaluate both the efficacy and safety of DAP/CPT versus alternative therapy for persistent MRSAB.

The data was presented at the 23rd Annual Making a Difference in Infectious Disease Meeting 2021 virtual sessions.

The retrospective, single-center study consisted of 68 patients with persistent MRSAB who had their initial therapy switched to either DAP/CPT or an alternative therapy. The primary outcomes was to compare inpatient mortality of DAP/CPT versus alternative therapy for persistent MRSAB.

Findings from the study showed that in-hospital mortality was similar between the groups, with the group receiving DAP/CPT experiencing 1 day less of bacteremia compared to the alternative therapy group.

Additionally, between the groups the length of stay, 90-day readmission, incidence of AKI or RRT initiation, CDI within 90 days, new ESBL or VRE infection/colonization within 90 days, and incidence of DAP discontinuation due to elevated CPK were also seen to be similar.

“Switching to DAP/CPT after approximately one week of persistent MRSAB resulted in similar outcomes to alternative therapy. Earlier treatment modification may be more beneficial and warrants further investigation,” the authors wrote. “Rates of adverse effects and emergence of antimicrobial resistance were low and did not differ between DAP/CPT and alternative therapy.”