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-drugresistant, 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 firstline 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. (c) 2023 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved.

Automated summary

This review evaluated the clinical evidence for the use of daptomycin in acute bacterial meningitis in both pediatric and adult patients. The results suggest that daptomycin could be a safe and effective alternative for the treatment of meningitis caused by Gram-positive bacteria. However, further research is needed to establish the optimal dosing regimen, duration of therapy, and place in therapy for the management of meningitis.