Daptomycin

Restricted
Restricted

C. diff Risk

Low

Oral Bioavailability

NA

Approximate Cost

Dosing

For endocarditis or bloodstream infection: 6-10mg/kg IV daily For non-bloodstream infections: 4mg/kg IV daily

Unknown for severe hepatic dysfunction

General Information

Common Usage

Targeted therapy of resistant gram positive infections with MRSA (particularly when MIC>=2) and VRE including endovascular infection

Drug Monitoring

Creatine kinase weekly.

Adverse Effects

Myopathy including rhabdomyolysis, GI side effects common, rash, phlebitis, increased INR

Major Interactions

Statins and fibrates: monitor creatine kinase or hold while on daptomycin therapy (increased myopathy)

Additional Information

Mandatory ID consult for use in PHC.

Higher doses used for endovascular infection.

Inactivated by pulmonary surfactant and therefore insufficient for pulmonary infection.

Pharmacology

Antimicrobial class: Cyclic lipopeptide, depolarizes bacterial cell membrane

Pregnancy category: B

Average serum half life: 9.0

CSF penetration: Poor

Lung penetration: Poor

Urine penetration: Therapeutic