Article in Japanese

Daptomycin use for children

Hideyuki OKUI, Chie FUKASAWA, Shoko TOKUTAKE, Tadashi HOSHINO

Daptomycin is characterized by rapid bactericidal activity and penetration of biofilm, and used to treat methicillin-resistant Staphylococcus aureus (MRSA) infection. However, it is not used generally in pediatric patients. We present 3 pediatric patients with systemic infection treated with daptomycin. Case 1 was a 9-month-old girl experiencing artificial filling infection with methicillin-resistant coagulase-negative staphylococci (MRCNS) after prosthetic valve replacement. Vancomycin treatment resulted in red man syndrome, with no negative findings on blood cultures after linezolid treatment. Consequently, daptomycin was administered. Case 2 was a 12-year-old boy who developed febrile neutropenia while having hemophagocytic syndrome associated with aplastic anemia. MRCNS was noted on blood and central venous catheter cultures. Teicoplanin treatment did not resulted in negative findings on blood cultures, and he became febrile after switching to vancomycin. As his trough concentration was inadequate after adjusting vancomycin dosage, the treatment was switched to daptomycin. Case 3 was a 1-month-old girl with acute myeloblastic leukemia, who developed febrile neutropenia. MRCNS was noted on her blood culture. Vancomycin treatment produced negative findings on blood culture, but the patient was still febrile, with inadequate trough concentration after adjusting vancomycin dosage. Consequently, her treatment was switched to daptomycin. In all 3 cases, MRCNS was observed on blood culture and the patients' condition was resolved with daptomycin. Daptomycin is a useful alternative drug when other antimicrobial agents for MRSA infection are ineffective or cannot be continued owing to adverse events. In addition, daptomycin may be useful in MRCNS infection cases.

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Division of Infectious Disease, Chiba Children's Hospital

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Received	January 14, 2015
Accepted	May 12, 2015

27 (2)：127─133,2015