Spectrum: Local Antimicrobial Stewardship, for AHS Calgary Zone

Daptomycin

C. diff Risk

Low

Oral Bioavailability

NA

Approximate Cost

$150/day+

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

Dosing

Adult

For endocarditis or bloodstream infection: 6-10mg/kg IV daily

For non-bloodstream infections: 4mg/kg IV daily

Hepatic

Unknown for severe hepatic dysfunction

Renal

General Information

Common Usage

Common Usage

Targeted therapy of resistant gram positive infections with MRSA (particularly when MIC>=2) and VRE including endovascular infection

Drug Monitoring

Drug Monitoring

Creatine kinase weekly

Adverse Effects

Adverse Effects

  • Myopathy including rhabdomyolysis

  • GI side effects common

  • Rash

  • Phlebitis

  • Increased INR

Major Interactions

Major Interactions

Statins and fibrates: monitor creatine kinase or hold while on daptomycin therapy (increased myopathy)

Additional Information

Additional Information

  • Mandatory ID consult for use in AHS.

  • Higher doses used for endovascular infection.

  • Recommend Infectious Disease Consult.

  • Inactivated by pulmonary surfactant and therefore insufficient for pulmonary infection.

Pharmacology

Pharmacology

Antimicrobial class: Cyclic lipopeptide, depolarizes bacterial cell membrane

Pregnancy category: B

Average serum half life: 9.0

CSF penetration: Poor

Lung penetration: Poor

Urine penetration: Therapeutic