Jason A Crompton

University of Michigan, Ann Arbor, MI, United States

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Publications (6)10.79 Total impact

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    ABSTRACT: To determine the safety of daptomycin administered using a variety of doses and dosing frequencies in patients receiving intermittent hemodialysis who had probable or confirmed gram-positive infections. Analysis of data from the Cubicin Outcomes Registry and Experience (CORE), a multicenter, retrospective, observational registry. Fifty-four study sites, mostly (46%) large teaching hospitals. Three hundred ninety-three adults in the CORE registry who received intermittent hemodialysis between 2005 and 2008. The CORE registry is noninterventional and collects standard-of-care data on daptomycin treatment from health care institutions. Of the 393 patients, 370 (94%) could be categorized by daptomycin dosing frequency: every 48 hours (251 patients [64%]), 3 times/week (87 [22%]), and every 24 hours (32 [8%]); the remaining 23 (6%) had unreported dosing frequencies or received a single dose of daptomycin. Three hundred eighty-four patients (98%) received part of their daptomycin therapy as an inpatient and 129 patients (33%) received part of their daptomycin therapy in an intensive care setting. The primary infection type was bacteremia (224 patients [57%]), and the most common pathogen was Staphylococcus aureus (155 patients [39%]). Thirty-eight adverse events possibly related to daptomycin occurred in 28 patients (7%); increased blood creatine kinase level (7 patients [1.8%]) was the most common adverse event. Adverse-event rates were similar across all dosing regimens. In these patients undergoing hemodialysis, daptomycin was a well-tolerated treatment for gram-positive infections across several doses and dosing frequencies. Further study in prospective trials is warranted.
    Pharmacotherapy 07/2011; 31(7):665-72. · 2.31 Impact Factor
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    ABSTRACT: Recent recommendations by the Infectious Diseases Society of America for the treatment of Staphylococcus aureus suggest the use of alternative agents when vancomycin MIC values are >or=2 mg/L. This study examines the outcome of patients treated with daptomycin for S. aureus infections with documented vancomycin MICs. All patients with skin, bacteraemia and endocarditis infections due to S. aureus with vancomycin MIC values in CORE 2005-08, a retrospective, multicentre, observational registry, were studied. The outcome (cure, improved, failure or non-evaluable) was the investigator assessment at the end of daptomycin therapy. Success was defined as cure or improved. Five hundred and forty-seven clinically evaluable patients were identified with discrete vancomycin MIC values [MIC <2 mg/L: 451 (82%); MIC >or=2 mg/L: 96 (18%)]. The vancomycin MIC groups were well matched for patient characteristics, types of infections, first-line daptomycin use (19%) and prior vancomycin use (58%). Clinical success was reported in 94% of patients. No differences were detected in the daptomycin success rate by the vancomycin MIC group overall or by the infection type. A multivariate logistic regression also failed to identify vancomycin MIC as a predictor of daptomycin failure. Adverse event (AE) rates were not different when analysed by MIC group; both groups had approximately 17% of patients with one AE. In this diverse population, daptomycin was associated with similar outcomes for patients, regardless of whether the vancomycin MIC was categorized as <2 or >or=2 mg/L. Further studies are warranted.
    Journal of Antimicrobial Chemotherapy 08/2010; 65(8):1784-91. · 5.34 Impact Factor
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    ABSTRACT: Purpose: Recent recommendations for S. aureus (SA) treatment suggest alternative agents when vancomycin MICs are ³ 2 µg/ml. This study examined the outcome of patients treated with daptomycin for SA infectious with recorded vancomycin MICs. Methods: All patients with SA infections with vancomycin MIC values in CORE 2005-2008, a retrospective, multicenter, observational registry, were studied. The outcome (cure, improved, failure, nonevaluable) was the investigator assessment at the end of daptomycin therapy. Success was defined as cure or improved. Results: 1158 patients with SA infections with vancomycin MIC values were identified. 729 (63%) patients had an evaluable outcome along with discrete vancomycin MIC values [MIC < 2: 606 (83%); MIC ³ 2: 123 (17%)]. The MIC ³ 2 group included 3 VISAs (MIC = 4) and 1 VRSA (MIC > 256). 52% were male and 59% were >50 yrs. No differences were found between vancomycin MIC groups for: daptomycin [initial dose, duration, monotherapy, first-line use (19%)], prior vancomycin use (47%) or failure (11%). The vancomycin MIC group ³ 2 had more patients with hematologic malignancy (7 vs. 3%; P = 0.02). The success rates for vancomycin MIC < 2 and ³ 2 mcg/ml, respectively, were: All patients (n=729), 571/606 (94), 113/123 (92); cSSSI (n=263) , 214/222 (96), 39/41 (95); uSSSI (n=124), 102/103 (99), 21/21 (100); Bacteremia (n=135), 99/107 (93), 24/28 (86); Endocarditis (n=25), 15/19 (79), 4/6 (67); Osteomyelitis (n=99), 82/86 (95), 12/13 (92); all Others (n=83), 59/69 (86), 13/14 (93); none were statistically different. A multivariate logistic regression also failed to identify vancomycin MIC as a predictor of daptomycin failure. Adverse event rates were similar; vancomycin MIC < 2 (7%) and ³ 2 (9%). Conclusion: In this diverse population, daptomycin was associated with similar outcomes for patients regardless of the vancomycin MIC being <2 or ³ 2 ug/ml. Further studies are warranted.
    2009 American College of Clinical Pharmacy Annual Meeting; 10/2009
  • J A Crompton, D S North, S A McConnell, K C Lamp
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    ABSTRACT: Antibiotic safety is a major determinant in osteomyelitis therapy. Limited data is available describing the long-term safety and efficacy of daptomycin. the safety population was drawn from CORE 2005 and 2006, a retrospective, observational, multicenter study. Clinically evaluable patients received >3 days of daptomycin appropriately adjusted for renal function. three hundred twenty-seven patients were evaluated for safety; 188 (57%) >or=6 mg/kg, 139 (43%) <6 mg/kg. Thirty-one (10%) patients experienced adverse events possibly related to daptomycin and the incidence was similar regardless of dose. No difference was observed in the rate of creatine phosphokinase elevations by dose. A trend toward higher improved rates was noted in patients receiving a final dose of >or=6mg/kg (96% vs. 90%, P=0.08). Daptomycin appeared well-tolerated at doses of 6 mg per kg or greater which were associated with greater clinical improvement. These results require verification via a prospective clinical trial.
    Journal of chemotherapy (Florence, Italy) 09/2009; 21(4):414-20. · 0.83 Impact Factor
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    ABSTRACT: Antibiotic treatment for pelvic inflammatory disease (PID) is often broad spectrum and targets a diverse range of vaginal flora. Treatment of PID in nursing mothers presents a particular clinical challenge because use of antimicrobials during breastfeeding poses several potential risks to infants. Excretion of drugs into breast milk can occur through different mechanisms and depends on the characteristics of both the drug and the mother. Whether daptomycin is excreted into breast milk is unknown, as is its subsequent exposure to breastfeeding infants and the associated risks. We describe a case of PID caused by methicillin-resistant Staphylococcus aureus, an uncommon pathogen in PID, in a breastfeeding mother who was successfully treated with daptomycin. Daptomycin concentrations in her breast milk were measured to determine potential exposure to her infant. These concentrations were extremely low, with an estimated milk:plasma ratio of 0.0012. Although additional confirmatory studies are needed, daptomycin may be a reasonable option in the treatment of PID caused by gram-positive organisms that are resistant to other antibiotics.
    Pharmacotherapy 04/2009; 29(3):347-51. · 2.31 Impact Factor
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    ABSTRACT: Purpose: The objective of this analysis was to characterize the use of daptomycin (DAP) in patients with urinary tract infections (UTI) with or without non-catheter-related-bacteremia (NCRB). Methods: Data are collected through an ongoing registry to characterize patterns of DAP use. Pts with a diagnosis of UTI and a positive urine culture for a Gram-positive pathogen from 2005 and 2006 were selected for this analysis. Pts with NCRB were only included if they had a positive blood culture with the same pathogen as the UTI. Only pts evaluable for outcome were included. Outcome was determined at the end of therapy as cure, improved, or failure. Results: 48 (44%) of 108 UTI pts met the criteria for inclusion. 75% of pts were female and 88% were in the hospital 48 hours prior to receiving DAP. Success rate (cure + improved) was 90%. 10 pts (21%) also had NCRB. Prior antibiotic therapy was utilized in 79% of pts with the most common being vancomycin (40%) and linezolid (19%). Prior antibiotic therapy was discontinued in 42% of pts due to the isolation of a resistant pathogen and in 19% of pts due to failure. The most common pathogens cultured from urine were enterococci (79%, of which 74% were resistant to vancomycin). S. aureus was isolated from urine in 19% of pts, of which 77% were MRSA. Two-thirds of pts with S. aureus had positive urine and blood cultures. The median (min, max) DAP dose and duration of therapy were 4 mg/kg (2.3, 11.4) and 8 days (2, 44), respectively. 35% of pts received a DAP dose ≥6 mg/kg and 63% of patients received an antibiotic along with DAP. Conclusions: DAP appears to be an effective treatment for UTI, including pts with NCRB. These data support the findings of the previously published findings of DAP efficacy in patients with complicated Gram-positive UTI.
    2008 American College of Clinical Pharmacy Annual Meeting; 10/2008