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Daptomycin use among children increasing in US hospitals
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Use of daptomycin among children is uncommon but increasing, according to study findings in the Journal of the Pediatric Infectious Diseases Society.
Beatriz Larru, MD, PhD, of The Children’s Hospital of Philadelphia, and colleagues assessed the use of daptomycin (Cubicin, Cubist) among hospitalized children aged younger than 18 years. Between January 2004 and December 2012, 1,035 hospitalizations with at least one dose of daptomycin occurred in 794 patients. Almost half of the study cohort was younger than 10 years of age.
Methicillin-resistant Staphylococcus aureus was present in 182 (17.6%) hospitalizations and Enterococcus were identified in 110 (10.6%) hospitalizations.
One third of daptomycin use was related to oncology. The median duration of daptomycin therapy was five days.
Vancomycin (35.5%), linezolid (Zyvox, Pharmacia & Upjohn) (12.7%), and clindamycin (11.4%) were the most common antibiotics used to treat MRSA 48 hours prior to daptomycin use. Each had a median duration of three days.
Linezolid (6.8%), trimethoprim/sulfamethoxazole (6.6%), and rifampin (4%) were the most common anti-MRSA antibiotics used in conjunction with daptomycin for at least 48 hours.
An estimated 14% of patients were treated with vancomycin within 24 hours of stopping daptomycin. Following daptomycin treatment, 83 (8%) patients were treated with linezolid; nine 0.9% were treated with quinupristin/dalfopristin (Synercid, Pfizer); and six (0.6%) were treated with tigecycline (Tygacil, Wyeth).
Daptomycin use began to steadily increase in 2004. A decrease in daptomycin use occurred in 2010, coinciding with an FDA warning that eosinophilic pneumonia may be associated with daptomycin use. Five hospitals did not administer daptomycin during the study period.
Larger studies are needed to determine the effectiveness and safety of daptomycin use among children, according to the researchers.
“Pediatric daptomycin use is uncommon but increasing. The variability of daptomycin use across large tertiary children’s hospitals justifies future studies assessing the efficacy and safety of daptomycin,” they concluded.
Disclosure: The researchers report no relevant financial disclosures.
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