Daptomycin

Restricted
C difficile risk
Low
Oral Bioavailability
N/A
Cost
$$$$$$

Spectrum Of Activity

Dosing

CrCl ≥30 mL/minCrCl <30 mL/min6-10 mg/kg IV Q24h4-6 mg/kg IV Q48h

4-6 mg/kg IV Q48h (doses given on HD days should be given after HD)

8 mg/kg IV Q48h

Unknown for severe hepatic dysfunction

Endocarditis or bloodstream infection 6-10mg/kg IV daily

Non-bloodstream infections 4mg/kg IV daily

General Information

Antimicrobial Stewardship approved criteria must be indicated at ORDER ENTRY.

Approved Indications:

  1. S.aureus with high vancomycin MIC (2 mcg/ml)
  2. Documented VRE from a non-urine source
  3. Documented vancomycin allergy - NOT Red Man's
  4. Vancomycin failure of therapy (>= 5 days)

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

Creatine kinase weekly

  • GI side effects common

  • Rash

  • Phlebitis

  • Increased INR

  • Myopathy including rhabdomyolysis

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

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