Daptomycin in the Treatment of Diabetic Foot Infections without Osteomyelitis; A Multicenter Study

Introduction: Although diabetic foot infections are polymicrobial, gram-positive microorganisms comprise the majority. Daptomycin is a novel agent in treating infections due to multidrug-resistant gram-positive pathogens. In this multicenter study, the outcomes of the daptomycin treatment were evaluated retrospectively in the treatment of diabetic foot infectious without osteomyelitis. Materials and Methods: Patients with diabetic foot infection without osteomyelitis and who received daptomycin treatment were included into the study. Sociodemographic characteristics of the patients, risk factors for methicillin resistant Staphylococcus aureus (MRSA), antimicrobial treatment, and the data of microbiological and clinical outcomes of the cases were registered in a standard form by eleven centers. Clinical success was defined as a combination of end-of-treatment laboratory parameters, clinical and microbiological responses. Results: A total of 46 patients (30 males, 16 females) were clinically evaluated for the outcome of daptomycin therapy. Mean age was 61.09 ± 11.82 years (31-81) and mean diabetes duration was 13 ± 8.2 years. The number of mild, moderate and severe infections identified according to the infection scoring system of the Infectious Diseases Society of America (IDSA) were 12 (26.1%), 25 (54.3%), and 9 (19.6%) respectively. Duration of daptomycin therapy was 17.5 ± 9.3 days and overall daptomycin success rate was 82.6% (n= 38). Two patients developed side effects. Conclusion: The clinical success rate of this study which assessed the efficacy of daptomycin in diabetic foot infections was 82.6%. Daptomycin can be safely used even in severe cases having had no success with previous antibiotic therapy.