Daptomycin

C. diff Risk

Low

Oral Bioavailability

NA

Approximate Cost

$150/day+

Dosing

General Pediatric

10 mg/kg/dose IV q24h
2 - 5 Years

7 mg/kg/dose IV q24h
6 - 11 Years

4-6 mg/kg/dose IV q24h
12+ Years

Renal

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

Other

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

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

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

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