CRD Summary: This review evaluated the effectiveness of daptomycin in the treatment of patients with Gram-positive cocci endocarditis and/or bacteraemia. It concluded that, although daptomycin appeared promising, there was limited clinical evidence available. Given the limitations of the included evidence, the cautious conclusion seems appropriate, but some studies may have been missed.

CRD Commentary: The review addressed a clear question with predefined inclusion criteria. Two relevant databases and references were searched, but there was no attempt to locate unpublished data. It was also unclear whether language restrictions were applied, so publication and language bias could not be ruled out. The authors did not state that they assessed validity but they did discuss some methodological issues of the included RCT. Data extraction was conducted in duplicate, but it was unclear whether similar methods were used to reduce error and bias during study selection. Given the limitations of the included evidence, the cautious conclusion seems appropriate. However, given the potential for publication and language bias, some studies may have been missed.