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Table 2 Details of management of VRE UTIs and outcome of daptomycin course

From: Use of daptomycin in the treatment of vancomycin-resistant enterococcal urinary tract infections: a short case series

Patient

Daptomycin dosing

Daptomycin treatment duration

Concomitant antibiotics

Posttreatment urine culture

Normal kidney function

1

7.5 mg/kg q24h

7 days

None

VRE eradicated

2

8 mg/kg q24h

3 days

None

VRE eradicated

3

13 mg/kg q24h*

10 days

None

VRE eradicated

Mild kidney disease (CKD 2)

4

5 mg/kg q24h

3 days

Fluconazole

VRE eradicated

5

5 mg/kg q24h

3 days

None

VRE eradicated

Moderate kidney disease (CKD 3)

6

5 mg/kg q24h

3 days

None

VRE eradicated

7

5 mg/kg q24h

3 days

Gentamicin 120 mg once a day

5 days after initiation of daptomycin; VRE eradicated

8

5 mg/kg q24h

3 days

None

VRE eradicated

Severe kidney disease/kidney failure (CKD 4–5)

9

5 mg/kg q24h

3 days

None

VRE eradicated

10

5 mg/kg q48h

3 days

None

VRE eradicated; patient died 2 days later (not related to infection)

  1. CKD chronic kidney disease, q24h once every 24 hours, q48h once every 48 hours, VRE vancomycin-resistant enterococci.
  2. As determined using the Cockcroft-Gault equation, CKD 2 = glomerular filtration rate (GFR) of 60–89 mL/min/1.73 m2, CKD 3 = GFR of 30–59 mL/min/1.73 m2, and CKD 4–5 = GFR of <30 mL/min/1.73 m2.
  3. Follow-up durations: microbiologic assessment (urine culture) ~3 days, clinical assessments up to ~7 days posttreatment.
  4. *Use of unusually high per-weight dose was recommended by the ID specialist for the concomitant management of Staphylococcus spp. bacteremia.
  5. ID consult resulted in clinical decision to treat q24h rather than q48h for more rapid results in this patient.