Daptomycin

ByBrian J. Werth, PharmD, University of Washington School of Pharmacy
Reviewed/Revised May 2024
View Patient Education

antibiotic that has a unique mechanism of action. It binds to the bacterial cell membranes, causing rapid depolarization of the membrane due to potassium efflux and associated disruption of DNA, RNA, and protein synthesis; the result is rapid concentration-dependent bacterial death.

Indications for Daptomycin

  • 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.

Contraindications to Daptomycin

Use of Daptomycin During Pregnancy and Breastfeeding

daptomycin crosses the placenta is unknown. Depending on the indication and the severity of illness, using daptomycin during pregnancy may be reasonable.

Adverse Effects of Daptomycin

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 often reversible but seldom occurs with once-a-day dosing. Nevertheless, rhabdomyolysis has been reported, and coadministration of daptomycin with other medications associated with myopathy, such as hydroxymethylglutaryl CoA reductase inhibitors (statins), may increase risk (1).

Adverse effects reference

  1. 1. Dare RK, Tewell C, Harris B, et al. Effect of Statin Coadministration on the Risk of Daptomycin-Associated Myopathy. Clin Infect Dis. 2018;67(9):1356-1363. doi:10.1093/cid/ciy287

Dosing Considerations for Daptomycin

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
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