C. diff Risk


Oral Bioavailability


Approximate Cost


Requires Infectious Disease consultation for use OR completion of the Restricted Antimicrobial order form for approved indications

Endocarditis or bloodstream infection
6-10mg/kg IV every 24 hr

Skin and soft tissue infections
4mg/kg IV every 24 hr

Unknown for severe hepatic dysfunction

General Information

Acceptable Uses

  • Gram positive infection resistant to beta-lactams and a serious vancomycin allergy (e.g. anaphylaxis, hives)

  • Failing vancomycin therapy - clinical decompensation or failure after at least 7 days therapy despite adequate source control and trough levels

  • VRE infection requiring IV therapy (when oral linezolid is unacceptable)

  • Staphylococcus infection with vancomycin MIC >2

Unacceptable Uses

  • Treatment of pneumonia, as daptomycin is inactivated by pulmonary surfactant

  • Empiric therapy for gram positive infections

  • VRE colonization of the urine, respiratory tract, or wounds.

Common Usage

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

Drug Monitoring


  • weekly creatinine kinase

  • periodic SCr


  • Muscle pain or weakness

  • GI effects

  • Hypersenistivity

  • peripheral neuropathy

Adverse Effects

  • GI side effects common

  • Rash

  • Phlebitis

  • Increased INR

  • Myopathy including rhabdomyolysis

Major Interactions

Statins and fibrates - Increased myopathy. Monitor creatine kinase or hold while on daptomycin therapy.

Additional Information

Higher doses used for endovascular infection.

Recommend Infectious Disease Consult.

Inactivated by pulmonary surfactant and therefore insufficient for pulmonary infection.


Antimicrobial class: Cyclic Lipopeptide.

Pregnancy category: B

Average serum half life: 9 hours

CSF penetration: Poor

Lung penetration: Poor

Urine penetration: Therapeutic