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Infection

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Daptomycin vs. glycopeptides in the treatment of febrile neutropenia: results of the Izmir matched cohort study

  • Oguz Resat Sipahi
  • Hasip Kahraman
  • Huseyin Aytac Erdem
  • Funda Yetkin
  • Selcuk Kaya
  • Tuna Demirdal
  • Ozlem Guzel Tunccan
  • Omer Karasahin
  • Ebru Oruc
  • Yasemin Cag
  • Behice Kurtaran
  • Mehmet Ulug
  • Murat Kutlu
  • Meltem Avci
  • Nefise Oztoprak
  • Bilgin Arda
  • Husnu Pullukcu
  • Meltem Tasbakan
  • Tansu Yamazhan
  • Ozlem Kandemir
  • Murat Dizbay
  • Hilal Sipahi
  • Sercan Ulusoy
Original Paper
  • 105 Downloads

Abstract

Purpose

In this multicentre, retrospective, matched cohort study we aimed to evaluate the outcomes of neutropenic fever cases that were treated with daptomycin or a glycopeptide (vancomycin or teicoplanin).

Methods

Data and outcomes of adult (aged > 18-years old) patients with neutropenic fever [(1) without clinical and radiological evidence of pneumonia, (2) who were treated with daptomycin or a glycopeptide (teicoplanin or vancomycin) for any reason and for at least 72 h] were extracted from the hospital databases. Matching was performed with all of the three following criteria: (1) underlying disease, (2) reason for starting daptomycin or glycopeptide (microbiologic evidence vs. microbiologic evidence, clinical infection vs. clinical infection and empirical therapy vs. empirical therapy) and (3) neutropenic status.

Results

Overall 128 patients [(69/123) (56.1%) in the daptomycin cohort (D) and 59/123 (48%) in the glycopeptide cohort (G)] had a resolution of fever at the end of 72 h antibiotic treatment (p = 0.25). There was no significant difference in cured, improved and (cured + improved) rates between (D) and (G) cohorts as well as fever of unknown origin cases or microbiologically confirmed infections or clinically defined infections subgroups (p > 0.05). There was also no significant difference (p > 0.05), in terms of persistent response in the (D) versus (G) cohorts,

Conclusions

These findings suggest that although not better, daptomycin efficacy is comparable to vancomycin if used as empiric therapy in the treatment of adult febrile neutropenia. We conclude that daptomycin may be used at least as a salvage therapy alternative to glycopeptides in the treatment of adult febrile neutropenia cases. A large, randomized-controlled trial may further consolidate the evidence related to this question.

Keywords

Lipopeptides Neutropenic fever Bacteremia Empirical therapy Linezolid 

Notes

Acknowledgements

Authors thank ESCMID Study Group for Infections in Compromised Hosts (Esgich). This research did not receive any specific grant from any party. Authors also thank Anthony Patterson, PhD (Assistant Professor in English Language and Literature in Celal Bayar University) and Emine Sevim Kocakız (English Teacher) for English proofreading.

Conflict of interest

ORS, SU, BA, HP and MT received speaker’s honorarium from MSD.

Supplementary material

15010_2018_1256_MOESM1_ESM.docx (17 kb)
Supplementary material 1 (DOCX 17 KB)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Oguz Resat Sipahi
    • 1
  • Hasip Kahraman
    • 1
  • Huseyin Aytac Erdem
    • 1
  • Funda Yetkin
    • 2
  • Selcuk Kaya
    • 3
  • Tuna Demirdal
    • 4
  • Ozlem Guzel Tunccan
    • 5
  • Omer Karasahin
    • 5
  • Ebru Oruc
    • 6
  • Yasemin Cag
    • 7
  • Behice Kurtaran
    • 8
  • Mehmet Ulug
    • 9
  • Murat Kutlu
    • 10
  • Meltem Avci
    • 11
  • Nefise Oztoprak
    • 12
  • Bilgin Arda
    • 1
  • Husnu Pullukcu
    • 1
  • Meltem Tasbakan
    • 1
  • Tansu Yamazhan
    • 1
  • Ozlem Kandemir
    • 13
  • Murat Dizbay
    • 5
  • Hilal Sipahi
    • 14
  • Sercan Ulusoy
    • 1
  1. 1.Department of Infectious Diseases and Clinical MicrobiologyEge University Faculty of MedicineIzmirTurkey
  2. 2.Department of Infectious Diseases and Clinical MicrobiologyInonu University Faculty of MedicineMalatyaTurkey
  3. 3.Department of Infectious Diseases and Clinical MicrobiologyKaradeniz Technical University Faculty of MedicineTrabzonTurkey
  4. 4.Department of Infectious Diseases and Clinical MicrobiologyKatip Celebi University Faculty of MedicineIzmirTurkey
  5. 5.Department of Infectious Diseases and Clinical MicrobiologyGazi University Faculty of MedicineAnkaraTurkey
  6. 6.Department of Infectious Diseases and Clinical MicrobiologyBaskent University Faculty of MedicineAdanaTurkey
  7. 7.Department of Infectious Diseases and Clinical MicrobiologyDr. Lütfi Kirdar Training and Research HospitalIstanbulTurkey
  8. 8.Department of Infectious Diseases and Clinical MicrobiologyCukurova University Faculty of MedicineAdanaTurkey
  9. 9.Infectious Diseases Clinic, Eskisehir Private Umit HospitalEskisehirTurkey
  10. 10.Department of Infectious Diseases and Clinical MicrobiologyPamukkale University Faculty of MedicineDenizliTurkey
  11. 11.Infectious Disease and Clinical Microbiology Clinicİzmir Bozyaka Training and Research HospitalIzmirTurkey
  12. 12.Department of Infectious Diseases and Clinical Microbiology ClinicAntalya Training and Research HospitalAntalyaTurkey
  13. 13.Department of Clinical Microbiology and Infectious Diseases, Faculty of MedicineMersin UniversityMersinTurkey
  14. 14.Bornova Health DirectorateIzmirTurkey

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