Treatment of complicated skin and skin structure infections caused by susceptible aerobic gram-positive organisms; Staphylococcus aureus bacteremia, including right-sided infective endocarditis caused by MSSA or MRSA

Daptomycin binds to bacterial membranes and causes a rapid depolarization of membrane potential. This loss of membrane potential causes inhibition of protein, DNA, and RNA synthesis, which results in bacterial cell death.

Steady-state trough concentrations were achieved by the third daily dose. Protein binding: 90 ~ 93%, 84% ~ 88% in patients with Clcr<30 mL/min. Distribution: 0.1 L/kg. Daptomycin is excreted primarily by the kidney approximately 78% and 5.7% of the dose was recovered from feces. Elimination half-life: 8-9 hours (up to 28 hrs in renal impairment)

Hypersensitivity to daptomycin.

B

Excretion in breast milk unknown/use caution

Diarrhea (5% to 12%), vomiting (3% to 12%), constipation (6% to 11%), Anemia (2% to 13%), Rash (4% to 7%), pruritus (3% to 6%), erythema (5%). HMG-CoA Reductase Inhibitors may enhance the adverse/toxic effect of DAPTOmycin. Specifically, the risk of skeletal muscle toxicity may be increased.

Complicated infection of skin AND/OR subcutaneous tissue: 4 mg/kg IV once every 24 hrs for 7 to 14 days. Staphylococcus aureus bacteremia, including right-sided endocarditis: 6 mg/kg IV every 24 hrs for a minimum of 2 to 6 weeks. Safety and efficacy in patients under the age of 18 have not been established. Dosage adjustment in adults: ClCr<30 mL/min, including hemodialysis or CAPD, complicated skin and skin structure infections: 4 mg/kg once every 48 hrs for 7 to 14 days；S. aureus bloodstream infections: 6 mg/kg IV once every 48 hrs for 2 to 6 weeks.

General dosing:
● Infants: Very limited data available; optimal dosing not established:
Infants <2 months:
IV: 6 mg/kg/dose every 12 hours; dosing reported in case series including former preterm and term neonates; one infant received a dose of 15 mg/kg/dose every 12 hours for endocarditis. Once-daily dosing of 8 mg/kg/dose (range: 6 to 12 mg/kg/dose) every 24 hours has also been reported in infants <3 months of age.
Infants 2 months:
IV: Usual dose: 8 to 10 mg/kg/dose every 24 hours; usual reported range: 6 to 14 mg/kg/dose every 24 hours.

●Children and Adolescents:
Note: Refer to indication-specific dosing if available; higher doses are recommended in some instances.
Children <2 years:
IV: 10 to 12 mg/kg/dose every 24 hours.
Children 2 to <7 years:
IV: 9 to 12 mg/kg/dose every 24 hours.
Children 7 to <12 years:
IV: 7 to 9 mg/kg/dose every 24 hours.
Children 12 years and Adolescents <18 years:
IV: 5 to 7 mg/kg/dose every 24 hours.

Dosage adjustment in adults: ClCr<30 mL/min, including hemodialysis or CAPD

No dosage adjustment necessary.

Store vials at 2~8℃. After reconstitution with NS，daptomycin solution is stable in the vial for 12 hrs at room temperature or up to 48 hrs when refrigerated. Stable in NS or LR; incompatible with dextrose-containing solutions