Weight-based antibiotic dosing in a real-world European study of complicated skin and soft-tissue infections due to methicillin-resistant Staphylococcus aureus

W. Lawson, D. Nathwani, C. Eckmann, S. Corman, J. Stephens, C. Solem, C. Macahilig, J. Li, N. Baillon-Plot, C. Charbonneau, S. Haider

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    Abstract

    We aimed to characterize real-world dosing of weight-based intravenous (IV) antibiotic therapy in patients hospitalized for methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft-tissue infections (cSSTIs). This was a subgroup analysis of a retrospective chart review that captured data from 12 European countries. The study included patients ≥18 years old, hospitalized with an MRSA cSSTI between 1 July 2010 and 30 June 2011 and discharged alive by 31 July 2011. Patients treated with IV vancomycin, teicoplanin or daptomycin at any stage during hospitalization were included in this analysis. Analyses were conducted at the regimen level (dosing in mg/kg or in mg, frequency, and total daily dose (TDD)), with potentially multiple regimens per patient, and the patient level, categorizing patients into low, standard (labelled) and high dosing groups according to their initial MRSA-targeted regimen. Among the 1502 patients in the parent study, 998 patients contributed a total of 1050 daptomycin, teicoplanin or vancomycin regimens. Across all regimens, the mean initial TDDs were 6.3 ± 1.9 mg/kg for daptomycin, 10.5 ± 4.9 mg/kg for teicoplanin and 28.5 ± 11.5 mg/kg for vancomycin. A total of 789 patients received first-line therapy with one of the above antibiotics. The majority of patients receiving first-line teicoplanin and daptomycin (96% and 80%, respectively) received higher than labelled cSSTI doses, whereas vancomycin doses were lower than labelled doses in >40% of patients. These real-world data reveal significant deviation from labelled antibiotic dosing in 12 European countries and the potential for suboptimal outcomes in patients with MRSA cSSTIs.

    Original languageEnglish
    Pages (from-to)S40-S46
    Number of pages7
    JournalClinical Microbiology and Infection
    Volume21
    Issue numberSuppl. 2
    Early online date20 Jul 2015
    DOIs
    Publication statusPublished - 1 Sep 2015

    Keywords

    • Administration, Intravenous
    • Adolescent
    • Adult
    • Aged
    • Aged, 80 and over
    • Anti-bacterial agents
    • Body weight
    • Daptomycin
    • Diabetes complications
    • Europe
    • Female
    • Humans
    • Male
    • Methicillin-resistant Staphylococcus aureus
    • Middle aged
    • Peripheral vascular diseases
    • Retrospective studies
    • Soft tissue infections
    • Staphylococcal skin infections
    • Teicoplanin
    • Vancomycin
    • Young adult

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