Daptomycin for the treatment of acute bacterial meningitis: A narrative review.

BACKGROUND: There is growing interest in the utilization of daptomycin for the treatment of multi-drug-resistant, Gram-positive infections. Pharmacokinetic studies suggest that daptomycin could penetrate into the cerebrospinal fluid, albeit to a small extent. The objective of this review was to evaluate the available clinical evidence for the use of daptomycin in acute bacterial meningitis of both paediatric and adult patients.

METHODS: Electronic databases were searched up to June 2022 for studies published on the topic. The inclusion criteria were met if the study reported the use of intravenous daptomycin (more than a single dose) for the treatment of diagnosed acute bacterial meningitis.

RESULTS: In total, 21 case reports were identified that met the inclusion criteria. These suggest that daptomycin could be a safe and effective alternative to achieve clinical cure of meningitis. In these studies, daptomycin was used in the event of treatment failure, patient intolerance or bacterial resistance to first-line agents.

CONCLUSIONS: Daptomycin has potential to be an alternative to standard care for meningitis caused by Gram-positive bacteria in the future. However, more robust research is required to establish an optimal dosing regimen, duration of therapy, and place in therapy for the management of meningitis.