Daptomycin

Restricted
C difficile risk
Low
Oral Bioavailability
N/A
Cost
$210-420/day

Dosing

Adult Soft Tissue InfectionBacteremia/other deep-seated infectionsObese Patients 4-6 mg/kg/day IV Max: 6 mg/kg/day See 'Additional Information' section 4 mg/kg every 24 hours6 mg/kg every 24 hoursSee 'Additional Information' Section

General Information

I.D. authorization required for adult and pediatric treatment

Recommend Infectious Disease Consult

Inactivated by pulmonary surfactant and therefore insufficient for pulmonary infection

Dosing Information All doses will be rounded to the nearest 50 mg. Round doses of 501-550 mg to 500 mg (one vial). Daptomycin flag order should be submitted for every patient receiving therapy. Doses greater than 6 mg/kg are not recommended at this time. In unusual circumstances, larger doses may rarely be indicated. Practitioners requesting the use of larger doses must obtain pharmacy authorization. Daptomycin will be administered daily at 1600 in order to facilitate batching of medication to prevent waste and decrease cost.

Obese Dosing If total body weight (TBW) is at least 30% greater than ideal body weight (IBW), use adjusted body weight (ABW) to more closely mimic the AUC and Cmax observed with normal-weighted individuals For daptomycin, ABW = IBW + [(TBW – IBW) x 0.6], taking into account 60% of the excess body weight IBW Males =50 kg +2.3 kg for each inch above 60 inches IBW Females =45 kg + 2.3 kg for each inch above 60 inches

VRE UTI Usage: More rapid response compared to ampicllin and vancomycin against E. faecalis animal models of pyelonephritis and UTI. In case series of 10 patients with VRE UTIs, daptomycin was clinically efficacious. Great activity against VRE catheter colonization and biofilm formation. Use for complicated UTIs

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