Daptomycin

C. diff Risk

Low

Oral Bioavailability

NA

Approximate Cost

$150/day+

Spectrum Of Activity

Dosing

Not routinely used as first-line therapy. The manufacturer recommends avoiding use in patients <12 months due to musculoskeletal, neuromuscular, and nervous system adverse effects observed in neonatal canine models

≥12 years: IV 4-6 mg/kg/DAY given as a single daily dose

≥6 years to <12 years: IV 7 mg/kg/DAY given as a single daily dose

2-6 years: IV 8-10 mg/kg/DAY given as a single daily dose

Very limited data available.
PMA ≥32 weeks: IV 12mg/kg/DAY divided q12h

Renally cleared, requires dosage adjustment with changes in renal function. Consult a pharmacist for renal dosing.

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, renal function

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

Recommend Infectious Disease Consult

Inactivated by pulmonary surfactant and therefore insufficient for pulmonary infection

Pharmacology

Antimicrobial class: Cyclic lipopeptide, depolarizes bacterial cell membrane

Average serum half life: Neonates and Infants <3 months: 6.2 hours
Children: 5 to 7 hours

Route of Elimination: 78% of the dose excreted in urine as unchanged drug; feces (6%)