Vol.66 No.4 July 2018
Retrospective study on the efficacy and safety of daptomycin and linezolid for secondary treatment of febrile neutropenia with suspected MRSA infection
1)Department of Pharmacy, Osaka City University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, Japan
2)Department of Infection Control, Osaka City University Hospital
3)Department of Infection Control Science, Osaka City University Graduate School of Medicine
Abstract
Glycopeptide antibiotics (GPs) as effective agents against anti-methicillin resistant Staphylococcus aureus (MRSA) are recommended for use in the treatment of drug-resistant gram-positive bacterial infection in febrile neutropenia (FN). However, there is no study that has investigated the efficacy and safety of daptomycin (DAP) or linezolid (LZD) as secondary treatments for FN. Therefore, in this study, we compared the efficacy and safety of DAP and LZD as second-line therapy for GPs refractory FN. This single-center, retrospective study included adult patients who received ether DAP or LZD as secondary treatment for FN. From their medical records, we investigated retrospectively the characteristics of the patients and their clinical laboratory values, vital signs, survival rate, clinical judgments and microbiological effects.
A total of 33 patients were included in the analysis. 20 patients received DAP and 13 patients received LZD as secondary treatment. No significant differences were observed in the characteristics of the patients between the groups. Body temperature and CRP levels after administration were significantly lowered, and no significant differences in the 30-day survival rate and clinical effects were identified between the groups. However, the defervescence rates within 4 days after initiating administration were significantly higher in the LZD group than in the DAP group (81.8% vs. 31.3%; p < 0.05).
This study suggests that DAP and LZD are both reasonable options for secondary treatment of FN patients. In particular, LZD has an early defervescence effect in FN patients through its anti-inflammatory properties.
Key word
daptomycin, linezolid, efficacy, safety, febrile neutropenia
Received
August 3, 2017
Accepted
February 14, 2018
Jpn. J. Chemother. 66 (4): 504-512, 2018
