Abstract

Objective: The aim of this study is to evaluate the effectiveness of daptomycin (DAP) in neutropenic patients with haematological malignancies.

Methods: We evaluated data of neutropenic patients treated with DAP in adult haematology unit of our hospital between January 2011 and April 2013. Neutropenia was classified as severe (<100/mm3), moderate (101-499/mm3), and mild (500-1000/mm3). Clinical outcomes included cure, improved, failed and nonevaluable response. Clinical success described patients with an outcome of cure or improved.

Results: 43 neutropenic patients who used DAP were identified. All had haematological malignancies and 21 (48.8%) had severe neutropenia. 40 (93%) patients received antibiotics prior to DAP. Skin and soft tissue infections (75%) were the most common diagnosis. Gram-positive organisms were identified only in 12 (27.9%) patients. Enterococcus faecium was the most common Gram-positive pathogen (n=7). The initial dose of DAP was 6 mg/kg in all patients and the median duration of therapy was 15.5 days (range 2-45). Overall clinical success was 82.5% (33/40). Clinical success rates were 84%, 72% and 90% in severe, moderate and mild neutropenic patients, respectively. The success rate in patients receiving DAP as first-line therapy was 100% (12/12) compared with 75% (21/28) success rate in patients who received DAP as second-line therapy. Success rates were 83% for bacteremia and 81% for skin and soft tissue infections. No adverse event related to DAP was reported.

Conclusions: Our data indicate that DAP is effective as first- and second-line therapy in the treatment of neutropenic patients with haematological malignancies.