Low
NA
Restricted to Infectious Disease physicians OR or patients with documentation of one of BMH's approved criteria for use
Endocarditis or bloodstream infection
6-10mg/kg IV every 24 hr
Skin and soft tissue infections
4mg/kg IV every 24 hr
Gram positive infection resistant to beta-lactams and a serious vancomycin allergy (e.g. anaphylaxis, hives)
Failing vancomycin therapy - clinical decompensation or failure after at least 7 days therapy despite adequate source control and trough levels
VRE infection requiring IV therapy (when oral linezolid is unacceptable)
Staphylococcus infection with vancomycin MIC >2
Transition of therapy to facilitate discharge - single dose use (in patients not going to a SNF)
Treatment of pneumonia, as daptomycin is inactivated by pulmonary surfactant
Empiric therapy for gram positive infections
VRE colonization of the urine, respiratory tract, or wounds
Targeted therapy of resistant gram positive infections with MRSA (particularly when MIC ≥ 2) and VRE including endovascular infection
Lab
Weekly creatinine kinase
Periodic SCr
Clinical
Muscle pain or weakness
GI effects
Hypersenistivity
Peripheral neuropathy
GI side effects common
Rash
Phlebitis
Increased INR
Myopathy including rhabdomyolysis
Statins and fibrates - Increased myopathy. Monitor creatine kinase or hold while on daptomycin therapy.
Higher doses used for endovascular infection.
Recommend Infectious Disease Consult.
Inactivated by pulmonary surfactant and therefore insufficient for pulmonary infection.
Antimicrobial class: Cyclic Lipopeptide.
Pregnancy category: B
Average serum half life: 9 hours
CSF penetration: Poor
Lung penetration: Poor
Urine penetration: Therapeutic
