Daptomycin

From IDWiki

Background

  • Cyclic lipopeptide antibiotic that is active against Gram-positive bacteria

Mechanism of Action

  • Mechanism of action is to depolarize the cell membrane

Pharmacokinetics and Pharmacodynamics

  • Distributes well into soft tissues and musculoskeletal system, as well as urine
    • Poor CNS penetrationpiva2019da
    • Good lung penetration, but is inactivated by lung surfactant and should not be used to treat pneumonia
  • Bactericidal
  • Concentration-dependent, best predicted by AUC24:MIC

Dosing

  • Standard dose: 6 mg/kg IV q24h
  • High dose for severe infections, including MRSA bacteremia: 8 to 10 mg/kg IV q24h

Renal Dosing

GFR (mL/min) Routine Dose High Dose
>50 6 mg/kg IV q24h 8-10 mg/kg IV q24h
11-50 6-8 mg/kg IV q24h
≤10 8 mg/kg IV q48h
HD 8 mg/kg IV q48h, dosed after dialysis
CRRT 8 mg/kg IV q48h