Comparative Analysis of Daptomycin and Vancomycin in the Treatment of Vertebral Osteomyelitis

Background Vertebral osteomyelitis is caused predominantly by Staphylococcus aureus, which is increasingly methicillin resistant. Our objective was to compare outcomes after use of vancomycin and daptomycin for treatment of vertebral osteomyelitis. Methods We conducted a retrospective chart review of all patients who received a diagnosis of vertebral osteomyelitis over a 6-year period at a tertiary care hospital in Memphis, Tennessee. Results Sixty-one patients were identified who received either vancomycin (n = 30) or daptomycin (n = 31) for vertebral osteomyelitis and had a follow-up period of at least 12 months. The mean duration of antibiotic therapy was 41 days in the vancomycin group and 45 days in the daptomycin group. Methicillin-resistant Staphylococcus aureus was identified in 81% of the vancomycin-treated patients and in 86% of the daptomycin-treated patients. Cure was significantly more likely to be obtained in the patients receiving daptomycin (97%) than in the patients treated with vancomycin (70%) (P = 0.0057). Conclusions When the mean duration of parenteral vancomycin or daptomycin approximates 6 weeks, cure rates for vertebral osteomyelitis equal or exceed 70%. The use of daptomycin resulted in a significantly higher rate of cure compared with that of vancomycin.