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Safety and effectiveness of daptomycin across a hospitalized obese population: results of a multicenter investigation in the southeastern United States.
Pharmacotherapy. 2013 Dec; 33(12):1322-30.P

Abstract

STUDY OBJECTIVE

Data are limited for antimicrobial outcomes in obese patients. This study investigated the safety and clinical outcomes of daptomycin therapy in a hospitalized obese population in the southeastern United States.

DESIGN

Multicenter retrospective cohort study.

SETTING

Thirteen hospitals in the southeastern United States.

PATIENTS

A total of 126 hospitalized adult obese patients (body mass index [BMI] more than 30 kg/m(2)) admitted from January 2005 through May 2010 who received daptomycin dosed on actual body weight for any indication for a minimum of 7 days.

MEASUREMENTS AND MAIN RESULTS

Primary safety outcomes included incidence of creatine phosphokinase (CPK) elevations more than 1000 units/L, more than 500 units/L, myalgias, and discontinuation of therapy due to adverse drug events (ADEs). Patients were stratified by BMI class (I, II, or III) for analyses. The average weight was 121 kg, and 39% of patients were considered morbidly obese. Factors associated with an increased risk of primary safety outcomes were assessed through regression analysis. Clinical effectiveness was evaluated as a secondary outcome. CPK elevations more than 1000 units/L occurred in 8.4% of evaluable patients and specifically in 1 (3.6%), 3 (10.3%), and 4 (10.5%) patients in BMI class I, II, and III, respectively (p=0.554). CPK elevations more than 500 units/L occurred in 13.7% of patients with no statistically significant difference noted across BMI classes. Discontinuation due to ADEs occurred in 8 patients (6.3%). One patient developed rhabdomyolysis on day 9 of therapy. Clinical effectiveness was documented in 71% of patients and was consistent across BMI classes.

CONCLUSION

Although elevations in CPK increased in high-risk obese patients on daptomycin, discontinuation rates due to ADEs remained low. Further evaluation in a prospective trial is warranted.

Authors+Show Affiliations

Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, University of South Carolina, Columbia, South Carolina.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

23712701

Citation

Bookstaver, P Brandon, et al. "Safety and Effectiveness of Daptomycin Across a Hospitalized Obese Population: Results of a Multicenter Investigation in the Southeastern United States." Pharmacotherapy, vol. 33, no. 12, 2013, pp. 1322-30.
Bookstaver PB, Bland CM, Qureshi ZP, et al. Safety and effectiveness of daptomycin across a hospitalized obese population: results of a multicenter investigation in the southeastern United States. Pharmacotherapy. 2013;33(12):1322-30.
Bookstaver, P. B., Bland, C. M., Qureshi, Z. P., Faulkner-Fennell, C. M., Sheldon, M. A., Caulder, C. R., & Hartis, C. (2013). Safety and effectiveness of daptomycin across a hospitalized obese population: results of a multicenter investigation in the southeastern United States. Pharmacotherapy, 33(12), 1322-30. https://doi.org/10.1002/phar.1298
Bookstaver PB, et al. Safety and Effectiveness of Daptomycin Across a Hospitalized Obese Population: Results of a Multicenter Investigation in the Southeastern United States. Pharmacotherapy. 2013;33(12):1322-30. PubMed PMID: 23712701.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safety and effectiveness of daptomycin across a hospitalized obese population: results of a multicenter investigation in the southeastern United States. AU - Bookstaver,P Brandon, AU - Bland,Christopher M, AU - Qureshi,Zaina P, AU - Faulkner-Fennell,Carmen M, AU - Sheldon,Margrit A, AU - Caulder,Celeste R, AU - Hartis,Charles, AU - ,, Y1 - 2013/05/26/ PY - 2013/5/29/entrez PY - 2013/5/29/pubmed PY - 2014/8/2/medline KW - HMG Co-A reductase KW - Staphylococcus aureus KW - creatine phosphokinase KW - daptomycin KW - morbid obesity KW - obesity SP - 1322 EP - 30 JF - Pharmacotherapy JO - Pharmacotherapy VL - 33 IS - 12 N2 - STUDY OBJECTIVE: Data are limited for antimicrobial outcomes in obese patients. This study investigated the safety and clinical outcomes of daptomycin therapy in a hospitalized obese population in the southeastern United States. DESIGN: Multicenter retrospective cohort study. SETTING: Thirteen hospitals in the southeastern United States. PATIENTS: A total of 126 hospitalized adult obese patients (body mass index [BMI] more than 30 kg/m(2)) admitted from January 2005 through May 2010 who received daptomycin dosed on actual body weight for any indication for a minimum of 7 days. MEASUREMENTS AND MAIN RESULTS: Primary safety outcomes included incidence of creatine phosphokinase (CPK) elevations more than 1000 units/L, more than 500 units/L, myalgias, and discontinuation of therapy due to adverse drug events (ADEs). Patients were stratified by BMI class (I, II, or III) for analyses. The average weight was 121 kg, and 39% of patients were considered morbidly obese. Factors associated with an increased risk of primary safety outcomes were assessed through regression analysis. Clinical effectiveness was evaluated as a secondary outcome. CPK elevations more than 1000 units/L occurred in 8.4% of evaluable patients and specifically in 1 (3.6%), 3 (10.3%), and 4 (10.5%) patients in BMI class I, II, and III, respectively (p=0.554). CPK elevations more than 500 units/L occurred in 13.7% of patients with no statistically significant difference noted across BMI classes. Discontinuation due to ADEs occurred in 8 patients (6.3%). One patient developed rhabdomyolysis on day 9 of therapy. Clinical effectiveness was documented in 71% of patients and was consistent across BMI classes. CONCLUSION: Although elevations in CPK increased in high-risk obese patients on daptomycin, discontinuation rates due to ADEs remained low. Further evaluation in a prospective trial is warranted. SN - 1875-9114 UR - https://www.unboundmedicine.com/medline/citation/23712701/Safety_and_effectiveness_of_daptomycin_across_a_hospitalized_obese_population:_results_of_a_multicenter_investigation_in_the_southeastern_United_States_ L2 - https://doi.org/10.1002/phar.1298 DB - PRIME DP - Unbound Medicine ER -