Daptomycin in treatment of Gram-positive infections in children with hematological disorders
https://doi.org/10.15690/vsp.v11i3.299
Abstract
The study of efficacy and toxicity of daptoycin in treatment of Gram-positive infectons n children with hematological disorders was
performed. Twelve patients (4 girls and 8 boys) with signs of Gram-positive infections were examined. Staphylococcus aureus was
found in 66,6% (8 patients), among them in 3 patients strains were methicillin-resistant; Staphylococcus epidermidis — was found in 16,6% (2 patients); Enterococcus faecalis — in 16,6% (2 patients). By the time of development of infectious complications 7 patients (58,3%) have received antibiotic treatment, in 5 other patients daptomycin was the first-line antibacterial drug. The mean dosage of the drug was 5,8 mg/kg/day. In order to reveal the drug toxicity the monitoring of biochemical serum markers (fibrinogen, ALT, AST, LDG, CPK, creatinine) was performed. The complete resolution of infectious complications occurred in 12,1 ± 4,3 days. The mean duration of daptomycin treatment was 14,2 ± 3,2 days. During the treatment reliable lower of fibrinogen (6,4 ± 1,1 g/l and 3,1 ± 0,9 g/l, р = 0,05) and c-reactive protein (CRP) (12,5 ± 7,1 mg/dL and 3,4 ± 1,8 mg/dL, р = 0,04) was observed. No side effects were observed in all the patients. The performed study allowed to make a conclusion, that daptomycin is an effective and safe drug in treatment of Grampositive infections in children with hematological disorders even with concomitant hypogranulocytosis.
Key words: daptomycin, Gram-positive infections, onco-hematology.
performed. Twelve patients (4 girls and 8 boys) with signs of Gram-positive infections were examined. Staphylococcus aureus was
found in 66,6% (8 patients), among them in 3 patients strains were methicillin-resistant; Staphylococcus epidermidis — was found in 16,6% (2 patients); Enterococcus faecalis — in 16,6% (2 patients). By the time of development of infectious complications 7 patients (58,3%) have received antibiotic treatment, in 5 other patients daptomycin was the first-line antibacterial drug. The mean dosage of the drug was 5,8 mg/kg/day. In order to reveal the drug toxicity the monitoring of biochemical serum markers (fibrinogen, ALT, AST, LDG, CPK, creatinine) was performed. The complete resolution of infectious complications occurred in 12,1 ± 4,3 days. The mean duration of daptomycin treatment was 14,2 ± 3,2 days. During the treatment reliable lower of fibrinogen (6,4 ± 1,1 g/l and 3,1 ± 0,9 g/l, р = 0,05) and c-reactive protein (CRP) (12,5 ± 7,1 mg/dL and 3,4 ± 1,8 mg/dL, р = 0,04) was observed. No side effects were observed in all the patients. The performed study allowed to make a conclusion, that daptomycin is an effective and safe drug in treatment of Grampositive infections in children with hematological disorders even with concomitant hypogranulocytosis.
Key words: daptomycin, Gram-positive infections, onco-hematology.
About the Authors
Z. M. Dyshlevaya
Russian Children Clinical Hospital of Ministry of Health Care and Social Development, Moscow
Russian Federation
Dyshlevaya Zarema Mikhailovna, Head of the Department of Hematology
Russian Federation
Dyshlevaya Zarema Mikhailovna, Head of the Department of Hematology
A. N. Arkhipova
Russian Children Clinical Hospital of Ministry of Health Care and Social Development, Moscow
Russian Federation
Russian Federation
Yu. V. Pashko
Russian Children Clinical Hospital of Ministry of Health Care and Social Development, Moscow
Russian Federation
Russian Federation
L. V. Guk
Russian Children Clinical Hospital of Ministry of Health Care and Social Development, Moscow
Russian Federation
Russian Federation
E. V. Skorobogatova
Russian Children Clinical Hospital of Ministry of Health Care and Social Development, Moscow
Russian Federation
Russian Federation
G. P. Pavlova
Russian Children Clinical Hospital of Ministry of Health Care and Social Development, Moscow
Russian Federation
Russian Federation
A. A. Bologov
Russian Children Clinical Hospital of Ministry of Health Care and Social Development, Moscow
Russian Federation
Russian Federation
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Review
For citations:
Dyshlevaya Z.M., Arkhipova A.N., Pashko Yu.V., Guk L.V., Skorobogatova E.V., Pavlova G.P., Bologov A.A. Daptomycin in treatment of Gram-positive infections in children with hematological disorders. Current Pediatrics. 2012;11(3):70-74. (In Russ.) https://doi.org/10.15690/vsp.v11i3.299
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