Administration
IV infusion over 30 minutes
May do IV push over 2 minutes
Can NOT be used with ReadyMED elastomeric infusion pumps due to chemical leaching into daptomycin solution
Preparation
Cubicin: Reconstitute with 10mL NS (concentration 50mg/mL)
Cubicin-RF: reconstitute with 10mL SWFI or bacteriostatic water (concentration 50mg/mL)
Daptomycin 350mg vial: reconstitute with 7mL NS (concentration 50mg/mL)
Gently swirl and rotate vial to wet powder and allow to sit until completely reconstituted. Do not shake or agitate
Further dilute in 50mL of NS
Compatibility
NS or LR
Incompatible in D5W
Targeted therapy of resistant gram positive infections with MRSA (particularly when MIC≥2) and VRE including endovascular infection
Tier Three
Last line option, but will be used more commonly in practice for specific cases of 1st line option inadequacy
Strategies used: ASP Prospective Audit with Feedback, Criteria-for-use
Appropriate use for sepsis, bacteremia or cellulitis when vancomycin dosing concern for AKI
Creatine phosphokinase weekly (also muscle pain/weakness or worsening peripheral neuropathy)
Signs/symptoms of eosinophilic pneumonia
Can get trough concentrations at steady-state (not recommended) or Cmax:MIC ratios
GI side effects common
Rash
Phlebitis
Increased INR
Myopathy including rhabdomyolysis
Chest pain
Edema
gram negative infections
Statins and fibrates - Increased myopathy. Monitor creatine kinase or hold while on daptomycin therapy.
Antimicrobial class: Cyclic Lipopeptide.
Pregnancy category: B
Average serum half life: 8-9 hours
Urine penetration: Therapeutic
Lung penetration: Poor
CSF penetration: Poor
Bone penetration: Poor to therapeutic
Cubicin, Cubicin-RF
Higher doses used for endovascular infection.
Recommend Infectious Disease Consult.
Inactivated by pulmonary surfactant and therefore insufficient for pulmonary infection.