Clinical Pharmacokinetics of Daptomycin

Abstract

Daptomycin is a new lipopeptide antibiotic for which preliminary pharmacokinetic data in adults have been limited to normal healthy volunteers and patients with renal insufficiency. We report the clinical pharmacokinetics of the first and fifth doses of iv daptomycin 150 mg (2 mg/kg) q24h in a 29-year-old man being treated for a gram-positive cellulitis and thrombophlebitis. Individual pharmacokinetic parameters yielded similar results during doses one and five. The pharmacokinetic profile observed in our patient did not markedly differ from data obtained from healthy volunteers.

Single-dose pharmacokinetics and antibacterial activity of daptomycin, a new lipopeptide antibiotic, in healthy volunteers

“…The pharmacokinetic values for daptomycin found in our studies were similar to values reported for a patient given 2 mg of daptomycin per kg (13). The disposition of daptomycin is different from that of other antibiotics with similar spectra of activity, most notably vancomycin.…”

Pacemaker-induced Staphylococcus aureus mitral valve acute bacterial endocarditis complicated by persistent bacteremia from a coronary stent: Cure with prolonged/high-dose daptomycin without toxicity

“…Daptomycin is equally effective against MSSA and MRSA strains causing bacteremia or endocarditis. [26][27][28][29][30][31] This patient's strain of MSSA was not resistant to daptomycin and in fact was found to be very susceptible by E-test, ie, MIC of .5 g/mL. Using 6 mg/kg, peak serum concentrations of approximately 99 g/mL are readily achievable and far in excess of what would be necessary to eradicate a strain of MSSA with an MIC of 0.5 g/mL.…”

“…Because of its bactericidal activity and ability to penetrate biofilms, daptomycin has been used successfully to treat prosthetic valve endocarditis in patients for whom valve removal was not a therapeutic option. [26][27][28]33 A higher-thanusual dose of daptomycin, ie, 12 mg/kg IV/24 h, was chosen to treat this patient because of its rapid bactericidal and high degree of activity against staphylococci and its ability to penetrate into device-covered biofilms, eg, coronary artery stent. Because surgical removal of the coronary artery stent, as the probable source of infection in this patient, was not clinically possible, we decided to try to eliminate the bacteremia by sterilizing the coronary artery stent with prolonged, high-dose daptomycin therapy.…”

Daptomycin: Pharmacokinetic, Pharmacodynamic, and Dose Optimization

“…No signifi cant difference in daptomycin PK was observed in healthy patients, HIV positive patients, and patients with liver function abnormalities (Dvorchik 2004 ;Pryka et al 1990 ). No dose adjustments are recommended at this time in patients with hepatic impairment or positive for human immunodefi ciency virus; however, further investigations with larger sample sizes are warranted.…”