Daptomycin
Mechanism :
Daptomycin binds to components of the cell membrane of susceptible organisms and causes rapid depolarization, inhibiting intracellular synthesis of DNA, RNA, and protein. Daptomycin is bactericidal in a concentration-dependent manner.
Indication :
- Treatment of complicated skin and skin structure infections
- S. aureus bacteraemia including those with right-sided infective endocarditis
- Cerebrospinal fluid shunt infection
- Diabetic foot infections
- Meningitis
- Osteomyelitis and/or septic arthritis
Contraindications :
Hypersensitivity to daptomycin or any component of the formulation.
Dosing :
IV
Skin and skin structure infections:
Duration of therapy: ≤14 days.
1 to <2 years: 10 mg/kg once daily.
2 to 6 years: 9 mg/kg once daily.
7 to 11 years: 7 mg/kg once daily.
12 to 17 years: 5 mg/kg once daily.
≥18 years: 4 mg/kg once daily.
S. aureus bacteremia:
Duration of therapy: ≤42 days
1 to 6 years: 12 mg/kg once daily.
7 to 11 years: 9 mg/kg once daily.
12 to 17 years: 7 mg/kg once daily.
≥18 years: 6 mg/kg once daily.
Adverse Effect :
Chest pain, hypertension, hypotension, insomnia, headache, dizziness, pruritus, diaphoresis, diarrhea, abdominal pain, UTI, abnormal hepatic function tests, gram-negative organism infection, bacteremia, increased creatine phosphokinase.
Interaction :
HMG-CoA Reductase Inhibitors (Statins): May enhance the adverse/toxic effect of Daptomycin. Specifically, the risk of skeletal muscle toxicity may be increased.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 30-50 | Dose as in normal renal function |
| <30 | 4 mg/kg every 48 hours |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in GFR<30 mL/min |
| HD | Not dialysed. Dose as in GFR<30 mL/min |
| HDF/High flux | Dialysed. Dose as in GFR<30 mL/ min |
| CAV/VVHD/VVHDF | Slightly dialysed. 4–6 mg/kg every 48 hours |
Hepatic Dose :
No dosage adjustments are recommended.