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Clinical Review |
CHRISTOPHER A. SCHRIEVER, PHARM.D., M.S., is Clinical Assistant Professor, Loyal University Medical Center, Maywood, IL. CRISTINA FERNANDEZ, PHARM.D., is Visiting Assistant Professor of Pharmacy Practice, Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago (UIC). KEITH A. RODVOLD, PHARM.D., and LARRY H. DANZIGER, PHARM.D., are Professors of Pharmacy Practice, Department of Pharmacy Practice, College of Pharmacy, and Section of Infectious Diseases, College of Medicine, UIC.
Address correspondence to Dr. Danziger at the Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, M/C 886, 833 South Wood Street, Room 164, Chicago, IL 60612-7230 (danziger{at}uic.edu).
Summary. Daptomycin, a novel cyclic lipopeptide antimicrobial, is bactericidal against a range of gram-positive bacteria, including many multiple-drug-resistant isolates. It has only minimal activity against anaerobic bacteria and no activity against gram-negative bacteria. Daptomycin exhibits linear pharmacokinetics, and the plasma concentration-versus-time relationship is best described by a two-compartment model with first-order elimination. The initial bactericidal activity is rapid, extensive, and concentration related. In clinical trials, daptomycin has shown efficacy in treating complicated skin and skin-structure infections (CSSSIs); the drug carries FDA-approved labeling for same. The adverse effects of daptomycin appear comparable to those of vancomycin and semisynthetic penicillins. The dosage for CSSSIs is 4 mg/kg by i.v. infusion every 24 hours.
Conclusion. Daptomycin is bactericidal against gram-positive organisms and offers an option in the treatment of CSSSIs.
Index terms: Antibiotics; Blood levels; Concentration; Daptomycin; Dosage; Drug administration; Excretion; Pharmacodynamics; Pharmacokinetics; Resistance; Skin diseases; Spectrum microbial; Toxicity
Purpose. The development, activity, pharmacokinetics, pharmacodynamics, clinical efficacy, adverse effects, and dosage and administration of daptomycin are reviewed.
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