Adult Dosing
Complicated skin and skin structure infections
- 4 mg/kg IV q24 hrs x 1-2 wks
Bloodstream infections (bacteremia)
- 6 mg/kg IV q24 hrs x 2-6 wks
Note: Therapy should be administered IV either by injection over a 2-minute period or by infusion over a 30-minute period
Pediatric Dosing
- Safety and effectiveness in patients under the age of 18 years have not been established
Cellulitis [Non-FDA Approved]
- 2-5 y: 10 mg/kg q24 hr
6-11 y: 7 mg/kg q24 hr- 12: Same as that for adults
[Outline]
Renal Dose Adjustment (Based on CrCl)
Complicated skin and skin structure infections
- 30 mL/min: 4 mg/kg IV q24 hrs
- <30 mL/min: 4 mg/kg IV q48 hrs after dialysis
Bloodstream infections (bacteremia)
- 30 mL/min: 6 mg/kg IV q24 hrs
- <30 mL/min: 6 mg/kg IV q48 hrs after dialysis
Hepatic Dose Adjustment
- Mild to moderate hepatic impairment (Child-Pugh Class A or B): No dose adjustments
- Severe hepatic impairment (Child-Pugh Class C): Dose adjustments not defined
- Therapy may cause anaphylaxis/hypersensitivity reactions which may be life-threatening. Discontinue the drug and institute appropriate therapy in such conditions
- Monitor for the development of muscle pain or weakness as myopathy and rhabdomyolysis can occur. Discontinue therapy if elevated CPK or myopathy occurs
- Discontinue drug and consider treatment with systemic steroids if eosinophilic pneumonia occurs
- Monitor for signs and symptoms of neuropathy and discontinue daptomycin if peripheral neuropathy occurs
- Carefully administer in patients with history of diarrhea as therapy may cause Clostridium difficile-associated diarrhea
- In patients with persisting or relapsing S. aureus bacteremia/endocarditis or poor clinical response, perform susceptibility testing and rule out sequestered foci of infection
- Prescribing daptomycin in the absence of a proven or strongly suspected bacterial infection may not provide any benefit and may increase the risk of developing drug-resistant bacteria; institute appropriate therapy in case superinfection occurs
- In patients with moderate baseline renal impairment, decreased clinical efficacy was observed
Caution: Use cautiously in
- Renal impairment
- Elderly patients
Pregnancy Category:B
Breastfeeding: Limited information indicates that daptomycin produces low levels in milk and it would not be expected to cause any adverse effects in breastfed infants. No special precautions are required. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 8 February 2011). Manufacturer advises caution when administering to nursing women.
