Daptomycin

KEY POINTS

• Works by causing depolarization of the cell membrane in sensitive organisms
• Used to treat infections caused by Gram positive bacteria (e.g., Staph, Strep, Enterococci)
• Has activity versus most MRSA and VRE, but beware resistance
• Dose in mg/kg once daily, but reduce to every other day if CrCl < 30 mL/min
• Beware CPK elevation, myalgias, arthralgias and rhabdomyolysis
  • Monitoring CPK and renal function more than weekly may be necessary in adults with renal impairment per a March 2017 FDA warning
• DO NOT USE FOR PNEUMONIA – it is inactivated by surfactant in the lung
• There is a Cubicin RF product of daptomycin that has longer stability and more convenient storage
  • Comparison of Cubicin versus Cubicin RF

RESOURCES

• Daptomycin Package Insert
• Eosinophilic Pneumonia FDA Alert
• MRSA Bloodstream Infection IDstewardship Post
• Evaluation of a Daptomycin Dose Optimization Protocol
• Daptomycin From The Mountain To The Clinic – CID
• The new, new daptomycin breakpoint for Enterococcus spp. – JCM
• Daptomycin FDA Warnings