Updated Antimicrobial Therapy for the Prevention and Treatment of Endocarditis: Focus on Daptomycin

Infective endocarditis is associated with significant clinical mortality and morbidity. With the increasing age of the general population and use of intra-cardiac devices it is occurring mainly in people over the age of 60 with male to female ratios ranging from 3:2 to 9. The predominant causative pathogens are staphylococci, and with the increase in the number of pathogens that are either resistant or exhibit reduced susceptibility the management of infective endocarditis is increasingly challenging. Recent guidelines have included the lipopeptide, daptomycin, in their recommendations. The body of evidence supporting the use of daptomycin in the treatment of infective endocarditis, including at doses above the licensed recommended dose of 6 mg/kg is increasing. The current review summarises the current recommendations for infective endocarditis and the place of daptomycin in its management.