Evidence map›Paper›PMID 41310831›Full record

ArticleCritical care (London, England)2025

Daptomycin is associated with higher treatment failure rates than alternatives for Enterococcus faecium bloodstream infections in critically ill patients: a multicentric retrospective cohort.

Simon Herbel, Guillaume Dumas, Louise Chantelot, Julien Massol, Sophie Nagle, Marie Lecronier, Matthieu Turpin, Quentin Moyon, Jean Damien Ricard, Matthieu Petit and 8 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors.

Simon HerbelService de Médecine Intensive-Réanimation, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France.
Guillaume DumasMedical Intensive Care Unit, Service de Médecine Intensive-Réanimation, CHU Grenoble-Alpes, Université Grenoble-Alpes, INSERM, U1042-HP2, Grenoble, France.
Louise ChantelotService de Médecine Intensive Réanimation, Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor-Albert Chenevier, 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.
Julien MassolService de Médecine Intensive-Réanimation, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, 27 rue du Faubourg Saint Jacques, 75014, Paris, France.
Sophie NagleRéanimation médico-chirurgicale, Hôpital Avicenne, AP-HP, Bobigny, France.
Marie LecronierService de Médecine Intensive-Réanimation (Département « R3S »), Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France.
Matthieu TurpinService de Médecine Intensive-Réanimation, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France.
Quentin MoyonService de Médecine Intensive-Réanimation, Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, 47-83, Boulevard de l'Hôpital, 75651, Paris Cedex, France.
Jean Damien RicardDMU ESPRIT, Service de Médecine Intensive Réanimation, Université Paris Cité, AP-HP, Hôpital Louis Mourier, Colombes, France.
Matthieu PetitMedical and Surgical intensive care unit, University Hospital Ambroise Paré, GHU Paris-Saclay, Assistance Publique Hôpitaux de Paris, Boulogne-Billancourt, France.
Elie AzoulayMedical Intensive Care UnitFamirea Study GroupClinical Epidemiology, UMR 1153, Center of Epidemiology and Biostatistics, APHP, Hôpital Saint-LouisECSTRA TeamSorbonne Paris Cité, CRESS, INSERM, Paris Diderot Sorbonne University, Paris, France.
Caroline Hauw-BerlemontService de Médecine Intensive Réanimation, Assistance Publique des Hopitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France.
Jacques TankovicAssistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Service de Bactériologie, Paris, France.
Jeremie JoffreService de Médecine Intensive-Réanimation, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France.
Hafid Ait-OufellaService de Médecine Intensive-Réanimation, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France.
Eric MauryService de Médecine Intensive-Réanimation, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France.
Tomas UrbinaService de Médecine Intensive-Réanimation, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France. tomas.urbina@aphp.fr.
ENTERODAPTO Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEnterococcal infections represent 10% of intensive care unit (ICU)-acquired infections and are associated with adverse outcomes, particularly in the case of E. faecium infections. Some studies focusing on non-critically ill patients have cast doubt on the non-inferiority of daptomycin compared to other antibiotics for these infections. We aimed to describe antibiotic treatment practices for monomicrobial E. faecium bloodstream infections (BSI) in patients admitted to the ICU, and to identify factors associated with treatment failure.

methodsThis retrospective multicenter study included adult patients presenting with a monomicrobial E. faecium BSI during their stay in one of 11 ICUs of Paris University hospitals between 2017 and 2022. Patients receiving daptomycin as a definitive antibiotic regimen were compared to those receiving another molecule using competing-risks models and propensity score-based analyses. The primary outcome was a composite criterion of treatment failure including: (1) prolonged bacteremia (≥3days) under treatment and/or (2) relapse within 30 days after the end of treatment and/or (3) the need for salvage therapy within 30 days.

resultsOf the 166 included patients, 26 received daptomycin as a definitive antibiotic regimen, at a median dose of 10 [10-10] mg/kg/day and 140 patients received non-daptomycin-based regimens (vancomycin (69%), linezolid (19%) or a beta-lactam (11%)). Source of BSI was predominantly unknown (38%), digestive (37%) or an intravascular device (16%). All isolates were vancomycin-susceptible. Median daptomycin MIC was 3 [2-3.25] mg/L. Time to adequate antibiotic regimen (1 [0-2] vs 1 [0-2] days, p=0.22) and rates of source control (63% vs 43%, p=0.17) were not different between groups. Regarding primary outcome, daptomycin as a definitive antibiotic regimen was associated with a higher rate of treatment failure in the multivariate adjusted analysis using a Fine and Gray model (aSHR 2.53 [1.14-5.62], p=0.022). Sensitivity analyses using propensity score overlap weighting (HR 2.48 [1.05-5.86], p=0.038) or with only patients treated by vancomycin as comparators (aSHR 2.26 [1.00-5.10], p=0.051) yielded similar results.

conclusionsIn this multicenter retrospective cohort of critically ill patients with monomicrobial E. faecium bloodstream infections, use of daptomycin as the definitive antibiotic regimen was associated with a higher rate of treatment failure. Further prospective studies are needed.

Indexed as

BacteremiaDaptomycinGram-Positive Bacterial InfectionsTreatment FailureAgedAnti-Bacterial AgentsCohort StudiesCritical IllnessEnterococcus faeciumFemaleHumansIntensive Care UnitsMaleMiddle AgedPropensity ScoreRetrospective StudiesAnti-Bacterial AgentsDaptomycinBloodstream infectionCritically illDaptomycinEnterococcus faeciumHealth care acquired infectionIntensive care unitVancomycin

Identifiers

PMID41310831
PMCPMC12659229

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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.