Daptomycin in the context of antimicrobial resistance in Gram-positive bacteria].

Francisco Javier Candel González

Servicio de Microbiología Clínica, Hospital Clínico San Carlos, Madrid, España. fj.candel@terra.es

Enfermedades infecciosas y microbiología clínica 2012 Feb

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Infection by antimicrobial-resistant Gram-positive bacteria (GPB) is highly prevalent, especially in the hospital setting. The increase in the use of glycopeptides has a microbiological cost: vancomycin-resistant strains (scarce), strains with intermediate sensitivity, heteroresistant and glycopeptide-tolerant strains and glycopeptide-sensitive strains but with a higher minimal inhibitory concentration require a higher dose of vancomycin, increasing toxicity. Because of its pharmacodynamics profile, linezolide has allowed more effective treatment of localized GPB infections in areas with complex spread and in ischemic tissues with little cost in terms of the selection of resistant strains. Similarly, because of its broad spectrum, tigecycline can be used to treat complex mixed infections caused by resistant pathogens. However, because linezolide and tigecycline are bacteriostatic agents, their use in the initial management of bacteremia, endocarditis and infection in immunocompromised hosts is limited. Because daptomycin has potent early bactericidal activity and has not been affected by heteroresistance or tolerance, this drug is an effective alternative against these severe GPB infections. Copyright © 2012 Elsevier España S.L. All rights reserved.

Citation

Francisco Javier Candel González. Daptomycin in the context of antimicrobial resistance in Gram-positive bacteria]. Enfermedades infecciosas y microbiología clínica. 2012 Feb;30 Suppl 1:10-6