Daptomycin: Difference between revisions

Latest revision as of 21:35, 15 July 2024

Distributes well into soft tissues and musculoskeletal system, as well as urine
- Poor CNS penetration1
- 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

Standard dose: 6 mg/kg IV q24h
High dose for severe infections, including MRSA bacteremia: 8 to 10 mg/kg IV q24h
Consider using adjusted body weight in obesity

CrCl (mL/min)	Routine Dose	High Dose
≥30	6 mg/kg IV q24h	8-10 mg/kg IV q24h
>30	6 mg/kg IV q48h	8 mg/kg IV q48h
HD	6 mg/kg IV q48h, dosed after dialysis	8 mg/kg IV q48h, dosed after dialysis
CRRT	6 mg/kg IV q48h	8 mg/kg IV q48h

^ S. Piva, Antonello Di Paolo, Laura Galeotti, Francesco Ceccherini, Francesco Cordoni, Liana Signorini, Tommaso Togni, Amedeo De Nicolò, Frank A. Rasulo, Nazzareno Fagoni, N. Latronico, Antonio D’Avolio. Daptomycin Plasma and CSF Levels in Patients with Healthcare-Associated Meningitis. Neurocritical Care. 2019;31(1):116-124. doi:10.1007/s12028-018-0657-y.

@@ Line 1: / Line 1: @@
+==Background==
-* Cyclic lipopeptide antibiotic that is active against Gram-positive bacteria
-* Mechanism of action is to depolarize the cell membrane
+*Cyclic lipopeptide antibiotic that is active against Gram-positive bacteria
-* Bactericidal
+===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 penetration[[CiteRef::piva2019da]]
+**Good lung penetration, but is inactivated by lung surfactant and should not be used to treat pneumonia
+*Bactericidal
+*Concentration-dependent, best predicted by AUC<sub>24</sub>:MIC
+== Dosing ==
+* Standard dose: 6 mg/kg IV q24h
+* High dose for severe infections, including [[MRSA bacteremia]]: 8 to 10 mg/kg IV q24h
+* Consider using [[adjusted body weight]] in obesity
+=== Renal Dosing ===
+{| class="wikitable"
+!CrCl (mL/min)
+!Routine Dose
+!High Dose
+|-
+|≥30
+|6 mg/kg IV q24h
+|8-10 mg/kg IV q24h
+|-
+|>30
+|6 mg/kg IV q48h
+|8 mg/kg IV q48h
+|-
+|HD
+|6 mg/kg IV q48h, dosed after dialysis
+|8 mg/kg IV q48h, dosed after dialysis
+|-
+|CRRT
+|6 mg/kg IV q48h
+|8 mg/kg IV q48h
+|}
+== Safety ==
+* Consider reducing or holding any statins while on daptomycin
+* Monitor CK
+* Monitor for eosinophilic pneumonitis
 [[Category:Cyclic lipopeptides]]