Spectrum: Local Antimicrobial Stewardship, for Prisma Health-Midlands

Daptomycin

Restricted
Restricted

C. diff Risk

Low

Oral Bioavailability

NA

Approximate Cost

$$$$$$

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

Dosing

Adult

Endocarditis or bloodstream infection 6-10mg/kg IV daily

Non-bloodstream infections 4mg/kg IV daily

Hepatic

Unknown for severe hepatic dysfunction

Renal

General Information

Acceptable Uses

Appropriate Use

Antimicrobial Stewardship approved criteria must be indicated at ORDER ENTRY.

Approved Indications:

  1. S.aureus with high vancomycin MIC (2 mcg/ml)
  2. Documented VRE from a non-urine source
  3. Documented vancomycin allergy - NOT Red Man's
  4. Vancomycin failure of therapy (>= 5 days)

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

  • GI side effects common

  • Rash

  • Phlebitis

  • Increased INR

  • Myopathy including rhabdomyolysis

Major Interactions

Major Interactions

Statins and fibrates - Increased myopathy. Monitor creatine kinase or hold while on daptomycin therapy.

Additional Information

Additional Information

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.

Pregnancy category: B

Average serum half life: 9 hours

CSF penetration: Poor

Lung penetration: Poor

Urine penetration: Therapeutic