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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Effects of prior effective therapy on the efficacy of daptomycin and ceftriaxone for the treatment of community-acquired pneumonia
Clinical Infectious Diseases, Volume 46, No. 8, Year 2008
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Description
Objective. We sought to compare daptomycin with ceftriaxone for the treatment of patients with community-acquired pneumonia (CAP). Methods. Two phase-3 randomized, double-blind trials that enrolled adult patients hospitalized with CAP were conducted. Patients received intravenous daptomycin (4 mg/kg) or ceftriaxone (2 g) once daily for 5-14 days. Aztreonam could be added for patients with gram-negative infections. Clinical responses at the test-of-cure visit among patients in the intent-to-treat and clinically evaluable populations were the primary efficacy end points. Results. After combining data from the trials, the intent-to-treat population included 413 daptomycin-treated patients and 421 ceftriaxone-treated patients, and the clinically evaluable population included 369 daptomycin-treated patients and 371 ceftriaxone-treated patients. In the intent-to-treat population, the clinical cure rate among daptomycin-treated patients with CAP was 70.9%, compared with 77.4% among ceftriaxone-treated patients (95% confidence interval for the difference between cure rates, -12.4% to -0.6%). In the clinically evaluable population, the clinical cure rate was lower among daptomycin-treated patients (79.4%) than among ceftriaxone-treated patients (87.9%; 95% confidence interval for the difference between cure rates, -13.8% to -3.2%). A posthoc analysis revealed that, among those who had received up to 24 h of prior effective therapy, cure rates were similar among daptomycin-treated (90.7%) and ceftriaxone-treated patients (88.0%; 95% confidence interval for the difference between cure rates, -6.1% to 11.5%). Conclusions. Daptomycin is not effective for the treatment of CAP, including infections caused by Streptococcus pneumoniae and Staphylococcus aureus. The observation that as little as 24 h of prior effective therapy may impact clinical outcome suggests that trials to evaluate CAP treatment may need to exclude patients who have received any potentially effective therapy before enrollment. © 2008 by the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Pertel, P. E.
United States, Lexington
Cubist Pharmaceuticals, Inc.
Bernardo, P.
United States, Lexington
Cubist Pharmaceuticals, Inc.
Fogarty, Charles M.
United States, Spartanburg
Spartanburg Housing
Matthews, Peter
South Africa, Middelburg
Middelburg Hospital
Northland, Rebeca G.
Chile, Santiago
Hospital de Carabineros
Benvenuto, Mark
United States, Lexington
Cubist Pharmaceuticals, Inc.
Thorne, Grace M.
United States, Lexington
Cubist Pharmaceuticals, Inc.
Luperchio, Steven A.
United States, Lexington
Cubist Pharmaceuticals, Inc.
Arbeit, Robert D.
United States, Boston
Paratek Pharmaceuticals, Inc.
Alder, Jeff
United States, Lexington
Cubist Pharmaceuticals, Inc.
Statistics
Citations: 147
Authors: 10
Affiliations: 5
Identifiers
Doi:
10.1086/533441
ISSN:
10584838
Research Areas
Disability
Study Design
Cross Sectional Study