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Daptomycin

By

Brian J. Werth

, PharmD, University of Washington School of Pharmacy

Last full review/revision May 2020
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Indications for Daptomycin

Daptomycin has activity against the following:

  • Gram-positive bacteria (broad-spectrum activity)

  • Multidrug-resistant gram-positive bacteria

Daptomycin is used mainly for infections caused by

However, methicillin-resistant S. aureus and vancomycin-resistant enterococci may become resistant during daptomycin therapy, resulting in relapsing or persistent infection.

Daptomycin is inferior to ceftriaxone for pneumonia, presumably because daptomycin can bind to pulmonary surfactant, reducing daptomycin’s activity in the alveolar epithelial lining fluid.

Contraindications to Daptomycin

Daptomycin is contraindicated in patients who have had an allergic reaction to it.

Use During Pregnancy and Breastfeeding

Animal reproduction studies with daptomycin have not shown risk to the fetus, and data related to pregnancy in humans are limited to case reports. The extent to which daptomycin crosses the placenta is unknown. Depending on the indication and the severity of illness, using daptomycin during pregnancy may be reasonable.

Daptomycin enters breast milk, but oral availability is low; effects on breastfeeding infants are unknown.

Adverse Effects of Daptomycin

Adverse effects of daptomycin include

Chronic use may cause reversible organizing pneumonia with eosinophilic pulmonary infiltrates, presumably because daptomycin binds to pulmonary surfactant and thus accumulates in the alveolar spaces.

Skeletal myopathy due to daptomycin is reversible but seldom occurs with once-a-day dosing.

Dosing Considerations for Daptomycin

Daptomycin is given parenterally once a day. Over 90% is bound to serum protein.

Dosing is adjusted for renal failure.

Because daptomycin can cause reversible skeletal myopathy, patients should be monitored for muscle pain or weakness, and serum creatine kinase levels should be checked weekly.

Drugs Mentioned In This Article

Drug Name Select Trade
No US brand name
CLEOCIN
CUBICIN
FLAGYL
MONUROL
ZYVOX
VIBATIV
DALVANCE
SIVEXTRO
ORBACTIV
BACTROBAN
AZACTAM
VANCOCIN
TINDAMAX
FORTAZ, TAZICEF
ZITHROMAX
BIAXIN
ERY-TAB, ERYTHROCIN
DIFICID
No US brand name
No US brand name
GENOPTIC
ANCEF, KEFZOL
FURADANTIN, MACROBID, MACRODANTIN
KEFLEX
THAM
No US brand name
CEFOTAN
MEFOXIN
No US brand name
CEFTIN, ZINACEF
No US brand name
No US brand name
SUPRAX
CLAFORAN
No US brand name
No US brand name
No US brand name
MAXIPIME
No US brand name
BACIIM
TYGACIL
ACHROMYCIN V
MINOCIN
BICILLIN L-A
No US brand name
PRIMSOL
MYCOBUTIN
VIBRAMYCIN
XERAVA
RIFADIN, RIMACTANE
No US brand name
PRIFTIN
XIFAXAN
DORIBAX
INVANZ
MERREM
AMOXIL
SULFAMYLON
No US brand name
BLEPH-10
No US brand name
NALLPEN IN PLASTIC CONTAINER
BACTOCILL IN PLASTIC CONTAINER
AZULFIDINE
BACTRIM, SEPTRA
DARAPRIM
SILVADENE
QUALAQUIN
CILOXAN, CIPRO
No US brand name
ZEMDRI
No US brand name
TOBI, TOBREX
No US brand name
NUZYRA
No US brand name
COLY-MYCIN M
ARALEN
PROGRAF
TIKOSYN
SEROQUEL
LANOXIN
OZURDEX
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