Nonadherence to treatment recommendations is a factor contributing to the clinical failure of daptomycin: Cohort study in Brazil
Braz. J. Pharm. Sci. (Online)
;
56: e17184, 2020. tab
Article
in English
| LILACS
| ID: biblio-1132039
ABSTRACT
To evaluate the clinical outcomes of daptomycin therapy and adherence to treatment recommendations, a retrospective cohort study was conducted with patients that received daptomycin during the period of the study. The adherence and nonadherence to clinical guidelines were assessed through organism identification, dose and time of treatment, management of bacteremia, and vancomycin treatment failure. A multiple logistic regression model analyzed the association between independent variables and clinical success (dependent variable), considering 5% of statistical significance. The study presented 52 patients who received daptomycin for the treatment of bacteremia (21.1%) or infections (osteomyelitis [63.5%], synovial fluid [15.4%]). Most patients (86.5%) received daptomycin as the second line of treatment, and 51.9% achieved clinical success. The patients had a better chance of clinical success when they followed the guideline indications (OR = 16.86; 95% CI = 1.45-195.88) and the medication was prescribed by a specialist in infectious diseases (OR = 4.84; 95% CI = 1.11-21.09). The study demonstrated lower clinical success than that described in the literature because of patients who were not eligible according to the clinical guidelines. Adherence to recommendations and appropriate prescription of reserve antibiotics is important in limiting early resistance, and avoiding clinical failure and unnecessary expenditure.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Cohort Studies
/
Treatment Failure
/
Daptomycin
/
Anti-Bacterial Agents
Type of study:
Etiology study
/
Practice guideline
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Braz. J. Pharm. Sci. (Online)
Journal subject:
Farmacologia
/
Teraputica
/
Toxicologia
Year:
2020
Type:
Article
Affiliation country:
Brazil
/
Spain
Institution/Affiliation country:
Autonomous University of Barcelona/ES
/
National Institute of Orthopedic Surgery/BR
/
Pediatric Institute Martagão Gesteira/BR
/
University of São Paulo/BR
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