In vitro Antifungal activity of leaf extracts from Aloe secundiflora, Bulbine frutescens, Vernonia lasiopus and Tagetes minuta against Candida albicans

Abstract

Background: Given the situation of multidrug resistance and therapeutic failure of traditional antibiotic therapy is necessary to have updated information on efficacy and tolerance of new antibiotics against Gram positive (GP) and Daptomycin (DPM) in the context of special guests immunocompromised, and patients with neoplasms (PN) solid or hematological, with or without neutropenia (NP). Aims. Evaluation of national data on efficacy and safety of Dpm in the treatment of various serious infections complicated by GP or PN from a European registry (EUCORE). Methods: Retrospective cohort study based on the selection and analysis of the PN included by Spanish researchers in the general database registry EUCORE (free communication experience and results of use of daptomycin in infections proven or highly suspected to be caused by GP) recorded between 2006 and September 2008 in Europe. Results: The Spanish contribution to record EUCORE (1127 patients) included 345 patients treated with Dpm, most treatments 'rescue' (290, 84%), a percentage of 35% in critical condition (n = 122) and having> 65 years 44% of them. The 40.32% of infections were caused by S. aureus (14.71% MRSA) and 30.83% for coagulase negative (ECN). Among them were detected 80 PN with cancer (23.19%), 21 of those admitted to the ICU. The type of cancer described in the study was hematologic cancer and solid organ cancer at the start or during the use of Dpm. 51% of them were treated with doses of 6mg/kg/d Dpm, and median days of treatment was 12 days, 14.5 days in cases of Np). GP bacteremia associated with vascular catheter (CV) (19, 24%) or not associated with CV (10, 12%) were the main types of infections in cancer patients. There were 9 infections associated with foreign bodies (11%) and 9 cases of endocarditis (11%), IcPTB 16 cases (20%). In terms of efficacy (removing 10% of evaluable patients) had successful overall therapeutic effectiveness in 77% of the NPs with cancer (83% in bacteremia, endocarditis 78%, 78% in foreign bodies). In the subgroup of PN with cancer to stay in ICU (21) the effective response rate was 81%. In the 14 PN with Np, the favorable response rate was 93% (75% in cases of bacteremia, 100% in the 6 patients with <500 neutrofilos/mm3). No adverse effects were detected that would force the withdrawal of the DAP, although in one case there was an increase in the number of CPK than 10 times. For the total patients (n = 345) were 36 patient died (10.43%), being just one of them possibly related to the drug and recorded as sudden death. Conclusions: Dpm constitutes a very important antibiotic option with good efficacy and safety results in the treatment of serious infections by GP in PN, with or without NP.