Conditions: Bacteremia
Keywords: Methicillin-resistant Staphylococcus aureus
Allocation: RANDOMIZED | Intervention model: PARALLEL
Enrollment: 11
Healthy volunteers: no

Brief summary:
There is an increased failure rate for the treatment of Staphylococcus Aureus Bacteremia (SAB) with traditional doses of vancomycin, the standard of care for patients with MRSA bacteremia over the last 40 years. This has been largely attributed to isolates with increased resistance to vancomycin (increased MIC). Daptomycin is an antibiotic that was approved several years ago for the treatment of SAB and is being increasingly used for MRSA bacteremia due to isolates with increased MIC. Increased doses have been recommended for both of these drugs in the treatment of this infection without a trial demonstrating their relative efficacy or safety at higher doses. This study will randomize patients with SAB due to MRSA with an increased MIC to determine the relative efficacy and safety of vancomycin and daptomycin used at higher than traditional doses.

Detailed description:

Arms:
arm 1: Vancomycin dosed to achieve a trough of 15-20 microgram/mL. arm 2: Daptomycin dosed at 8 mg/kg/daily (every 48 hours in end-stage renal disease)

Interventions: intervention 1: Vancomycin intervention 2: Daptomycin
Intervention descriptions: intervention 1: Vancomycin dosed to achieve a trough of 15-20 microgram/mL. intervention 2: None

Protocol document: