Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Daptomycin Plus Fosfomycin Versus Daptomycin Alone for Methicillin-resistant Staphylococcus aureus Bacteremia and Endocarditis: A Randomized Clinical Trial.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 76 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Randomized Multicenter Study to Assess Efficacy of Daptomycin Plus Fosfomycin Versus Daptomycin Monotherapy for Treatment of Methicillin Resistant Staphylococcus Aureus Bacteremia in Hospitalized Patients
Adjunctive Fosfomycin for Treatment of Staphylococcus Aureus Bacteraemia: Protocol for a Pooled Post-hoc Analysis of Two Randomised Clinical Trials
Who cites it
76 citing papers in PubMed, 2 syntheses or guidelines pooled it, 132 citations in OpenAlex.
- Antibiotic synergy againstAntimicrobial agents and chemotherapy · 2025Pooled it
- The effect of combining antibiotics on resistance: A systematic review and meta-analysis.eLife · 2024Pooled it
- Preclinical and clinical evaluation of vancomycin plus delpazolid combination therapy for MRSA bacteremia: a multicenter, double-blinded, randomized, parallel design, phase IIa clinical trial.Microbiology spectrum · 2026Trial
- Cloxacillin plus fosfomycin versus cloxacillin alone for methicillin-susceptible Staphylococcus aureus bacteremia: a randomized trial.Nature medicine · 2023Trial
- Rationalizing Heterogeneity in Staphylococcus aureus Bacteremia: Current Progress and Future Goals.The Journal of infectious diseases · 2026Review
- Methicillin-resistant Staphylococcus aureus.Nature reviews. Disease primers · 2026Review
- The global epidemiology of MRSA.JAC-antimicrobial resistance · 2026Review
- Combination antibiotic therapy in Staphylococcus aureus endocarditis: evidence, controversies, and future directions.Infection · 2026Review
- Host-driven remodelling of theMicrobiology (Reading, England) · 2026Review
- ASP-COMPLEX: redefining antimicrobial stewardship to improve outcomes in high-risk patients with severe infections.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Review
- Identification and characteristics of a novel fosfomycin glutathione transferase, FosA12, from an MDR clinical isolate ofAntimicrobial agents and chemotherapy · 2026Article
- Subphenotype- and complication-guided adjunctive fosfomycin versus standard monotherapy inThe Lancet regional health. Europe · 2026Article
- Adjunctive Fosfomycin for the Treatment of Staphylococcus aureus Bacteremia: A Pooled Post Hoc Analysis of Individual Participant Data From 2 Randomized Trials.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Methicillin-resistant and susceptible Staphylococcus aureus: tolerance, immune evasion and treatment.Nature reviews. Microbiology · 2026Review
- [Staphylococcus aureus bacteremia: the long road to adequate therapy : Recent studies].Innere Medizin (Heidelberg, Germany) · 2026Review
- Fatal Panton-Valentine leukocidin-positive MSSA toxic shock syndrome: a call for rapid virulence detection and optimized antimicrobial therapy.Frontiers in cellular and infection microbiology · 2026Article
- Impact on daptomycin resistance using combination of daptomycin plus ceftaroline in daptomycin-susceptible and -resistantFEMS microbes · 2026Article
- Analysis of Clinical Subphenotypes in Methicillin-ResistantOpen forum infectious diseases · 2025Article
- Intravenous Fosfomycin for Gram-Negative and Gram-Positive Bacterial Infections: A Systematic Review of the Clinical Evidence.Antibiotics (Basel, Switzerland) · 2025Review
- Therapeutic approach to difficult-to-treat multidrug-resistant enterococcal infections.Antimicrobial agents and chemotherapy · 2025Review
16 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
37 authors at 19 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe aimed to determine whether daptomycin plus fosfomycin provides higher treatment success than daptomycin alone for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and endocarditis.
methodsA randomized (1:1) phase 3 superiority, open-label, and parallel group clinical trial of adult inpatients with MRSA bacteremia was conducted at 18 Spanish hospitals. Patients were randomly assigned to receive either 10 mg/kg of daptomycin intravenously daily plus 2 g of fosfomycin intravenously every 6 hours, or 10 mg/kg of daptomycin intravenously daily. Primary endpoint was treatment success 6 weeks after the end of therapy.
resultsOf 167 patients randomized, 155 completed the trial and were assessed for the primary endpoint. Treatment success at 6 weeks after the end of therapy was achieved in 40 of 74 patients who received daptomycin plus fosfomycin and in 34 of 81 patients who were given daptomycin alone (54.1% vs 42.0%; relative risk, 1.29 [95% confidence interval, .93-1.8]; P = .135). At 6 weeks, daptomycin plus fosfomycin was associated with lower microbiologic failure (0 vs 9 patients; P = .003) and lower complicated bacteremia (16.2% vs 32.1%; P = .022). Adverse events leading to treatment discontinuation occurred in 13 of 74 patients (17.6%) receiving daptomycin plus fosfomycin, and in 4 of 81 patients (4.9%) receiving daptomycin alone (P = .018).
conclusionsDaptomycin plus fosfomycin provided 12% higher rate of treatment success than daptomycin alone, but this difference did not reach statistical significance. This antibiotic combination prevented microbiological failure and complicated bacteremia, but it was more often associated with adverse events. CLINICAL TRIALS REGISTRATION: NCT01898338.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.