Estudio de prescripción-indicación de daptomicina en el Hospital Central de la Defensa «Gómez Ulla»

Abstract

Daptomycin is a bactericidal antimicrobial, active against gram-positive bacteria; indicated by summary product characteristics (SmPC) in the treatment of complicated skin and soft tissue infections, right infective endocarditis caused by S. aureus, and S. aureus bacteremia if it is associated with one of them. However, daptomycin is also prescribed in other indications, or other doses than those approved, arising the need to analyze its use. Patients and methods: Design: drug utilization study of the type prescription- indication, retrospective; in Hospital Central de la Defensa «Gómez Ulla», from July 15 to October 31, 2019. Objective: to know indications and the use of daptomycin. Sampling and sample size: consecutive non-probabilistic, N = 30. Ad hoc preparation of the data collection logbook, including clinical, demographic and pharmacological characteristics. Karch and Lasagna’s modified algorithm to determine the causal relationship of adverse drug reactions suspicion. Descriptive statistical analysis with SPSS 25.0 program. Results: In 87% (26/30) of the cases the indication was adapted to SmPC; complicated skin and soft tissue infections and bacteremia were the most prevalent indications. Despite the recommendations in the SmPC, 17% (5/30) of the patients had a creatinine clearance less than 30 ml/min, but there was no renal adjustment of the dose regimen, and in 64% (19/30) of the cases there was no CPK control. There was one case of an increase in CPK with a «probable» causality relationship. Conclusions: Absence of significant deviations from the indications of daptomycin. The need for informative intervention regarding safety is objectified: a) adjustment according to the patient’s renal function and b) control of CPK levels before and during treatment.