Lower Daptomycin Concentrations May Occur in Patients with Severe Sepsis

Daptomycin clearance was increased among patients with severe sepsis or septic shock; in dosing simulations, 750 mg daily seemed to be optimal.

Studies have shown marked variability in the pharmacokinetics of daptomycin in acutely ill patients. Although use of 6 mg/kg daily is suggested for treating infections caused by gram-positive organisms, high-dose (10 mg/kg daily) daptomycin is recommended for persistent methicillin-resistant Staphylococcus aureus bacteremia not responsive to vancomycin.

In a recent open-label, prospective study conducted in Italy, researchers sought to ascertain the optimal dosing of daptomycin in critically ill patients. Fifty adults who were receiving 6 or 8 mg/kg of daptomycin daily for serious bacterial infections (most caused by methicillin-resistant Staphylococcus) had plasma daptomycin concentrations measured sequentially during the course of therapy.…

Reviewing Author

Neil M. Ampel, MD

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Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Lower Daptomycin Concentrations May Occur in Patients with Severe Sepsis

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Reviewing Author