RT Book, Section
A1 Gruenberg, Katherine
A1 Guglielmo, B. Joseph
A2 Papadakis, Maxine A.
A2 McPhee, Stephen J.
A2 Rabow, Michael W.
A2 McQuaid, Kenneth R.
SR Print(0)
ID 1193122187
T1 Daptomycin
T2 Current Medical Diagnosis & Treatment 2023
YR 2023
FD 2023
PB McGraw-Hill Education
PP New York, NY
SN 9781264687343
LK accessmedicine.mhmedical.com/content.aspx?aid=1193122187
RD 2024/04/19
AB Daptomycin  is  a  bactericidal  lipopeptide  with  a  spectrum  of  activity  similar  to  that  of  linezolid  or  quinupristin-dalfopristin.  This  spectrum  includes  methicillin-resistant  staphylococci  and  VRE;  however,  MICs  are  much  lower  for  the  former  than  the  latter.  Daptomycin  has  poor  oral  bioavailability  and  thus  is  only  available  as  a  parenteral  product.  Its  long  pharmacologic  half-life  allows  for  once-daily  dosing  (approved  at  4  mg/kg  every  24  hours  in  skin  and  soft  tissue  infection  and  6  mg/kg,  every  24  hours  in  the  treatment  of  bacteremia  and  right-sided  endocarditis);  dosage  adjustment  is  necessary  in  the  presence  of  kidney  disease.  IDSA  recommends  8–10  mg/kg  daily  to  treat  serious  infection;  doses  up  to  12  mg/kg  are  recommended  by  some  experts  for  treatment  of  vancomycin-resistant  Enterococcus.  The  primary  adverse  event  associated  with  daptomycin  is  a  reversible,  dose-dependent  myopathy  observed  with  7  days  or  more  of  therapy.  Considering  this  complication,  monitoring  of  serum  creatine  kinase  levels  is  recommended,  particularly  in  those  patients  receiving  long-term  therapy.  Daptomycin  cannot  be  used  in  the  treatment  of  primary  respiratory  tract  infection  because  pulmonary  surfactant  binds  daptomycin,  resulting  in  subtherapeutic  free  drug  concentrations  in  pulmonary  secretions.