[Challenges in the antimicrobial treatment of infective endocarditis. Role of daptomycin]

Abstract

Infections caused by Gram-positive organisms are currently a therapeutic problem because of the emergence and spread of strains with multiple resistance to antibiotics used as first-line therapeutic options. Glycopeptides, considered as alternative drugs, have limited effectiveness in the treatment of serious infections caused by these microorganisms, including infective endocarditis. Among the new antimicrobial agents recently licensed for use in human therapy, daptomycin offers a good clinical efficacy profile in both clinical trials and in experiences of clinical use registered after approval. Because of its bactericidal activity and potential synergy with other antimicrobial agents, such as beta-lactams, fosfomycin and aminoglycosides, daptomycin is among the first-line options in the treatment of infections caused by staphylococci and probably enterococci with multiple resistance to antibiotics. Daptomycin also offers an excellent safety profile and a very low rate of resistance. Further studies, including many patients with this serious infection, should precisely determine the clinical efficacy of daptomycin in this indication.