2)  COPD 8 (30.8)  Hypertension 21 (80.8)  Arterial coronary disease 14 (53.9)  Severe renal chronic failure (<30 mL/min) 1 (3.9)  Moderate renal chronic failure (30–60 mL/min) 7 (26.9) Clinical presentation at entry  Intracavitary PVGI 18 (69.2)  Extracavitary PVGI 8 (30.8)  Early PVGI 14 (53.9)  Late PVGI 12 (46.2)  Fever 21 (80.8)  Local erythema 15 (57.7) Quisinostat chemical structure  Productive fistula 14 (53.9)  Abdominal pain 8 (30.8)  Septic shock 6 (23.1)  Weight (mean ± SD;

kg) 76.2 ± 11.7 Biological data at entry  Creatinine clearance (mean ± SD; mL/min) 82.9 ± 33  WBC (mean ± SD; /mm3) 12,445 ± 5,389  C-reactive protein (mean ± SD; mg/L) 102 ± 96 Microbiological data  Positive blood sample 9 (34.6)  Positive intraoperative sample 21 (80.8)  No bacterial growth 5 (19.2)  Polymicrobial sample 5 (19.2)  MSSA 11 (42.3)  MRSA 5 (19.2)  CNS 2 (7.7)  Streptococcus sp. 5 (19.2)  Enterococcus faecalis 2 (19.2)  Gram-negative bacilli 8 (30.8)  Fungi 1 (3.9) Initial treatment option of PGVI  PVGI removed 17 (65.4)  Debridement in situ

without prosthetic removal 6 (23.1)  Medical treatment without surgery 3 (11.5) Outcome  New surgery 12 (46.2) Previous or concomitant treatment  Previous antibiotic treatment 16 (61.5)  Concomitant treatment with statins 9 (34.6) Sotrastaurin in vivo CNS coagulase-negative staphylococci, COPD chronic obstructive pulmonary disease, MRSA methicillin-resistant Fenbendazole Staphylococcus aureus, MSSA methicillin-sensitive Staphylococcus aureus, PVGI prosthetic vascular graft infection, WBC white blood cells aVaules are presented as n (%) unless otherwise stated Fig. 1 Creatine phosphokinase (CPK) and creatinine level rate during daptomycin (DAP) regimen Discussion Results of the present study suggest that DAP >8 mg/kg/day, when used to treat a variety of PVGI due

to Gram-positive cocci in severely ill patients with multiple comorbidities, shows a favorable safety profile, in agreement with previous studies, as well as a satisfactory clinical success rate [19–22]. Most of our patients were over 65 and severely ill, with high risk of mortality, sepsis, renal disorders due to the sepsis, vasopressor drug use, occlusive arterial disease, and “clampage of the aorta”. Despite these recognized risk factors in renal failure, nephrotoxicity was not detected in our population of patients, in contrast to results of VS-4718 research buy vancomycin therapy reported in recent clinical studies [26, 27]. Several patients in our study experienced increased CPK blood levels, some with concomitant statins. With or without statins, clinical and biological abnormalities disappeared within a week. In pre-clinical studies [28, 29], DAP has been linked to fully reversible skeletal muscle toxicity, with no effect on smooth or cardiac muscle. A significant rise in the CPK level was noted, from 2.5% to 8.3%.