II. Indications
- Organisms
- Methicillin-Resistant Staphylococcus Aureus (MRSA)
- Streptococcal Species
- Vancomycin Sensitive Enterococcus
- Conditions
- Complicated Skin Infections
- Endocarditis
- Do not use for Pneumonia
- Poorly penetrates lung
- Inactivated by surfactant
III. Mechanism
- Cyclic Lipopeptide
- Depolarizes Bacterial cell membrane
IV. Dosing: Adult
- Complicated Skin Infections including MRSA
- Daptomycin 4 mg/kg in NS IV over 30 minutes once daily for 7 to 14 days
- Right sided endocarditis due to Staphylococcus Aureus
- Daptomycin 6 mg/kg in NS IV over 30 minutes once daily for 2 to 6 weeks
- AHA/IDSA guideline allows for injection over 2 minutes as alternative to infusion (not FDA approved)
-
MRSA Bacteremia (or Endocarditis) High Dose regimen (not FDA approved)
- Daptomycin 6 to 8 mg/kg in NS IV over 30 minutes once daily for 2 to 6 weeks
- Left sided MSSA Endocarditis (AHA, not FDA approved)
- Daptomycin 8 mg/kg in NS IV over 30 minutes once daily for up to 6 weeks
- Multi-drug Resistant Enterococcal Endocarditis (AHA, not FDA approved, consult infectious disease)
- Daptomycin 10 to 12 mg/kg in NS IV over 30 minutes once daily for up to 6 weeks
-
Vancomycin-Resistant MRSA Bacteremia (not FDA approved)
- Daptomycin 10 mg/kg in NS IV over 30 minutes once daily for up to 6 weeks
- MRSA Osteomyelitis
- Daptomycin 6 mg/kg in NS IV over 30 minutes once daily
-
Renal Dosing (eGFR <30 ml/min or Hemodialysis)
- eGFR <30 ml/min: 4 mg/kg IV every 48 hours for Skin Infections (6 mg/kg for s. aureus bacteremia)
- Daptomycin efficacy may be lower when eGFR <50 ml/min
V. Dosing: Child
- Complicated Skin Infections including MRSA
- Age 12 to 17 years: Daptomycin 5 mg/kg in NS IV over 30 minutes once daily for 7 to 14 days
- Age 7 to 11 years: Daptomycin 7 mg/kg in NS IV over 30 minutes once daily for 7 to 14 days
- Age 2 to 6 years: Daptomycin 9 mg/kg in NS IV over 30 minutes once daily for 7 to 14 days
- Age 1 to 2 years: Daptomycin 10 mg/kg in NS IV over 30 minutes once daily for 7 to 14 days
-
Staphylococcus Aureus bacteremia (endocarditis)
- Age 12 to 17 years: Daptomycin 7 mg/kg in NS IV over 30 minutes once daily for up to 6 weeks
- Age 7 to 11 years: Daptomycin 9 mg/kg in NS IV over 30 minutes once daily for up to 6 weeks
- Age 1 to 6 years: Daptomycin 12 mg/kg in NS IV over 60 minutes once daily for up to 6 weeks
VI. Pharmacokinetics
VII. Adverse Effects
-
Muscle toxicity or Myopathy
- Avoid concurrent Statin use
- Neuropathy
- Eosinophilic Pneumonia (rare)
- Hepatotoxicity
- Diarrhea
- Rash
VIII. Safety
- Pregnancy Category B
- Unknown safety in Lactation
IX. Drug Interactions
- INR
- False elevation of PT/INR
X. Monitoring
- Weekly labs while on Daptomycin
- Renal Function (if renal Impairment)
- Serum CPK
XI. Resources
- Daptomycin (DailyMed)
- Daptomycin (StatPearls)
XII. References
- (2004) Med Lett Drugs Ther 46(1175): 11-2
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
Images: Related links to external sites (from Bing)
Related Studies
Definition (MSH) | A cyclic lipopeptide antibiotic that inhibits GRAM-POSITIVE BACTERIA. |
Definition (NCI) | A semi-synthetic cyclic lipopeptide antibiotic isolated form the bacterium Streptomyces roseosporus with broad-spectrum antibiotic activity against Gram-positive bacteria. Daptomycin has a distinct mechanism of action, in which it binds to bacterial membrane and causes rapid depolarization of the cell membrane due to calcium-dependant potassium efflux; the loss of membrane potential leads to inhibition of DNA, RNA and protein synthesis, resulting in bacterial cell death. This agent does not penetrate the outer membrane of gram-negative bacteria. |
Definition (NCI_NCI-GLOSS) | A drug used to treat certain bacterial skin and bloodstream infections in adults. Cubicin is also being studied in the treatment of fever and neutropenia (an abnormal decrease in the number of neutrophils, a type of white blood cell) in patients with cancer. It is a type of antibiotic. |
Definition (PDQ) | A semi-synthetic cyclic lipopeptide antibiotic isolated form the bacterium Streptomyces roseosporus with broad-spectrum anitbiotic activity against Gram-positive bacteria. Daptomycin has a distinct mechanism of action, in which it binds to bacterial membrane and causes rapid depolarization of the cell membrane due to calcium-dependant potassium efflux; the loss of membrane potential leads to inhibition of DNA, RNA and protein synthesis, resulting in bacterial cell death. This agent does not penetrate the outer membrane of gram-negative bacteria. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=469015&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=469015&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C47470" NCI Thesaurus) |
Concepts | Antibiotic (T195) , Amino Acid, Peptide, or Protein (T116) |
MSH | D017576 |
SnomedCT | 406438001, 406439009 |
LNC | LP33354-9, MTHU016673 |
English | Daptomycin, Deptomycin, N-Decanoyl-L-tryptophyl-L-asparaginyl-L-aspartyl-L-threonylglycyl-L-ornithyl-L-aspartyl-D-alanyl-L-aspartylglycyl-D-seryl-threo-3-methyl-L-glutamyl-3-anthraniloyl-L-alanine epsilon1-lactone, N-decanoyl-L-tryptophyl-L-asparaginyl-L-aspartyl-L-threonylglycyl-L-ornithyl-L-aspartyl-D-alanyl-L-aspartylglycyl-D-seryl-threo-3-methyl-L-glutamyl-3-anthraniloyl-L-alanine-epsilon1-lactone, daptomycin (medication), Daptomycin [Chemical/Ingredient], DAPTOmycin, daptomycin, Daptomycin (product), Daptomycin (substance), DAPTOMYCIN |
Swedish | Daptomycin |
Czech | daptomycin |
Finnish | Daptomysiini |
Russian | DAPTOMITSIN, ДАПТОМИЦИН |
Japanese | ダプトマイシン |
Polish | Daptomycyna |
Spanish | daptomicina (producto), daptomicina (sustancia), daptomicina, Daptomicina |
French | Daptomycine |
German | Daptomycin |
Italian | Daptomicina |
Portuguese | Daptomicina |
Ontology: Cyclic lipopeptide antibiotic (C1320334)
Concepts | Antibiotic (T195) , Organic Chemical (T109) |
SnomedCT | 406437006, 406440006 |
Spanish | lipopéptidos cíclicos, lipopéptidos cíclicos (producto), lipopéptidos cíclicos (sustancia), antibiótico lipopeptídico cíclico, antibiótico lipopeptídico cíclico (sustancia), antibiótico lipopeptídico cíclico (producto), antibióticos lipopéptidos cíclicos (producto), ántibióticos lipopéptidos cíclicos (sustancia), antibióticos lipopéptidos cíclicos, ántibióticos lipopéptidos cíclicos |
English | Cyclic lipopeptides, Cyclic lipopeptide antibiotic (product), Cyclic lipopeptide antibiotic (substance), Cyclic lipopeptide antibiotic, Cyclic lipopeptides (product), Cyclic lipopeptides (substance) |
Ontology: Cubicin (C1330170)
Concepts | Amino Acid, Peptide, or Protein (T116) , Antibiotic (T195) |
MSH | D017576 |
English | Cubist Brand of Injectable Daptomycin, Cubicin |