Antimicrobials
Daptomycin

Daptomycin

Restricted

Low
N/A

Dosing

General Information

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

Pregnancy:

  • Information on daptomycin in pregnancy is limited.
  • No adverse effects were observed in three infants whose mothers had been treated with daptomycin, two in the second trimester and the other in the third trimester of pregnancy.
  • Adverse events or congenital malformations were not observed in animal reproduction studies.

Breastfeeding:

  • Very limited information indicates that daptomycin produces very low levels in milk.
  • Daptomycin is also poorly orally absorbed.
  • There were no adverse effects reported in infants of two case reports of breastfeeding mothers who received daptomycin 500 mg IV daily (one for 2 weeks, one for 4 weeks).

Creatine kinase weekly.

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

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

Mandatory ID consult for use in PHC.

Higher doses used for endovascular infection.

Inactivated by pulmonary surfactant and therefore insufficient for pulmonary infection.

Antimicrobial class: Cyclic lipopeptide, depolarizes bacterial cell membrane

Average serum half life: 9.0

CSF penetration: Poor

Lung penetration: Poor

Urine penetration: Therapeutic