Daptomycin lock therapy for grampositive long-term catheter-related bloodstream infections.

INTRODUCTION: To evaluate the efficacy of Daptomycin (DPT) lock therapy in the treatment of Grampositive long-term catheter-related bloodstream infections (LT-CRBI).

PATIENTS AND METHODS: A retrospective review of all patients receiving DPT lock therapy for the treatment of LT-CRBI from December 2009 to May 2010 was conducted. The primary endpoint used in this study was failure to cure the episode of LT-CRBI. Cure was defined as fever disappearance, negative blood cultures within 1 month after the end of treatment, and catheter salvage.

RESULTS: Thirteen subjects (seven men, mean age 62 years) were evaluated. There were six Staphylococcus epidermidis, two Staphylococcus hominis, one Staphylococcus haemolyticus, two Enterococcus faecalis and two polymicrobial (S. epidermidis and S. hominis) bloodstream infections. DPT lock therapy was administered for a mean of 14 days (interquartilic range 10-14). Intravenous DPT was administered in nine patients for a mean of 10 days (interquartilic range 5-11). Clinical cure and blood culture sterilisation occurred in 11 of 13 patients (85%). Two patients had fever during treatment and catheters were removed. Median length of follow-up in patients with therapeutic success was 67 days (interquartilic range 14-88).

CONCLUSION: DPT lock therapy demonstrated good in vivo efficacy in LT-CRBI caused by coagulase negative staphylococci and Enterococcus species.