High-dose daptomycin as salvage therapy for staphylococcal left-sided infective endocarditis: a retrospective analysis of 14 cases
10.3760/cma.j.issn.1674-2397.2025.03.005
- VernacularTitle:大剂量达托霉素挽救治疗葡萄球菌左心感染性心内膜炎14例临床分析
- Author:
Liying ZHU
1
;
Wenjing WANG
1
;
Zhen TAO
1
Author Information
1. 南京市第一医院感染性疾病科，南京 210006
- Publication Type:Journal Article
- Keywords:
Infective endocarditis;
Staphylococcus;
High-dose daptomycin;
Salvage therapy
- From:
Chinese Journal of Clinical Infectious Diseases
2025;18(3):199-203
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical efficacy of high-dose daptomycin as salvage therapy for staphylococcal left-sided infective endocarditis（IE）.Methods:A retrospective analysis was conducted on 14 patients with staphylococcal left-sided IE who received high-dose daptomycin（≥8 mg·kg?1·d?1）as salvage therapy at Nanjing First Hospital between November 2016 and February 2022. Data on clinical characteristics，laboratory and imaging findings，treatment regimens，and outcomes were analyzed using descriptive statistics.Results:Among the 14 patients，9 had prosthetic valve endocarditis. Echocardiographic findings included vegetations（ n=9），paravalvular leakage（ n=6），and paravalvular abscesses（ n=2）；4 patients had ≥2 valvular lesions. Pathogens were methicillin-resistant Staphylococcus aureus（MRSA， n=3），methicillin-sensitive Staphylococcus aureus（MSSA， n=2），and methicillin-resistant coagulase-negative Staphylococcus（MRCNS， n=9）. Clinical treatment success was achieved in 8 patients. Treatment failure occurred in 6 patients，including 2 deaths，one discontinued medication due to hypersensitivity reaction and one discontinued medication due to elevated creatine phosphokinase（CK）levels. Conclusion:High-dose daptomycin demonstrates moderate efficacy as salvage therapy for staphylococcal left-sided IE. However，adverse reactions，including hypersensitivity and elevated CK levels，necessitate vigilant clinical monitoring.
