1736. Daptomycin (D) in Enterococcal left-sided infective Endocarditis (ELSIE)
Session: Poster Abstract Session: Treatment of Bacteremia and Endocarditis
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Daptomycin (D) in Enterococcal left-sided infective Endocarditis (ELSIE).pdf (372.2 kB)
  • Background:

    Infective Endocarditis due to Entorococcus spp. is a challenge for physicians. D is a cyclic lipopetide antibiotic highly active against grampositive bacteria (include enterococcus). It is recommended for use in cases of right-sided IE. Observational studies have shown the efficacy of D to treat ELSIE.

    The aim of this study was to evaluate the effectiveness of daptomycin in ELSIE (native and prosthetic valve)

    Methods:

    Prospective, observational cohort study of consecutives cases of LSIE caused by Enterococcus spp.  according to modified Duke Criteria, in adults patients (pts).

    Results:

    From 1/2009 to 12/2012, 65 pts were treated with D; 36 had LSIE (55.38%). Of those 16 had ELSEI (44%). Of the 16 pts evaluated: male 62.5%; age 71 (median; DS= ±10.4).  IE definite 15/16 (93.75%). Native valve IE 7 (43.75%), prosthetic valve IE 9 (56.25%).  All patients were treated with high doses (>8 mg/kg); treatment duration 31 days (median; r=5-42 days). D was a second line treatment in 12/16 pts (75%) and the combination of Ampicilin with Ceftrixone was the more frequent antibiotic used at first. 11 patient received another antibiotic with D. The most used was Amoxicilin. Five pts underwent valvular surgery during the acute phase of the disease. Clinical success rate 16/16 (100%) pts. Elelven patient complete their treatment in a “outpatient parenteral antimicrobial therapy (OPAT) modality (median: 29.6 days; r= 15-40).  Just 1 patient had intolerance to D, and another one had an increase of his CK levels. No one had relapse. 1 patient had another episode of IE by another microorganism (St. bovis) 2 years later.  

    Conclusion:

    We had very good results whit Daptomycin in patient whit left side endocarditis by enterococcus, with no significant side effects even though the use of high doses (>8 mg/k/d). Clinical success was high in this difficult-to-treat population included those with prothetic valves.

    Pablo Fernandez Oses, MD1, Francisco Nacinovich, MD1,2 and Adriana Sucari2, (1)Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina, (2)Fundación Centro de Estudios Infectológicos, Ciudad Autónoma de Buenos Aires, Argentina

    Disclosures:

    P. Fernandez Oses, None

    F. Nacinovich, Pfizer: Scientific Advisor, Speaker honorarium

    A. Sucari, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.