Daptomycin: Difference between revisions
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==Background== |
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*Cyclic lipopeptide antibiotic that is active against Gram-positive bacteria |
*Cyclic lipopeptide antibiotic that is active against Gram-positive bacteria |
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===Mechanism of Action=== |
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*Mechanism of action is to depolarize the cell membrane |
*Mechanism of action is to depolarize the cell membrane |
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===Pharmacokinetics and Pharmacodynamics=== |
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*Distributes well into soft tissues and musculoskeletal system, as well as urine |
*Distributes well into soft tissues and musculoskeletal system, as well as urine |
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**Poor CNS penetration |
**Poor CNS penetration[[CiteRef::piva2019da]] |
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**Good lung penetration, but is inactivated by lung surfactant and should not be used to treat pneumonia |
**Good lung penetration, but is inactivated by lung surfactant and should not be used to treat pneumonia |
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*Concentration-dependent, best predicted by AUC<sub>24</sub>:MIC |
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== Dosing == |
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* Standard dose: 6 mg/kg IV q24h |
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* High dose for severe infections, including [[MRSA bacteremia]]: 8 to 10 mg/kg IV q24h |
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* Consider using [[adjusted body weight]] in obesity |
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=== Renal Dosing === |
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{| class="wikitable" |
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!CrCl (mL/min) |
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!Routine Dose |
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!High Dose |
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|- |
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|≥30 |
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|6 mg/kg IV q24h |
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|8-10 mg/kg IV q24h |
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|- |
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|>30 |
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|6 mg/kg IV q48h |
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|8 mg/kg IV q48h |
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|- |
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|HD |
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|6 mg/kg IV q48h, dosed after dialysis |
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|8 mg/kg IV q48h, dosed after dialysis |
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|- |
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|CRRT |
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|6 mg/kg IV q48h |
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|8 mg/kg IV q48h |
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|} |
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== Safety == |
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* Consider reducing or holding any statins while on daptomycin |
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* Monitor CK |
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* Monitor for eosinophilic pneumonitis |
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[[Category:Cyclic lipopeptides]] |
[[Category:Cyclic lipopeptides]] |
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Latest revision as of 01:35, 16 July 2024
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 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
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
| 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
References
- ^ 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.
