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Daptomycin: an evidence-based review of its role in the treatment of Gram-positive infections

Authors Gonzalez-Ruiz A, Seaton RA, Hamed K

Received 24 October 2015

Accepted for publication 14 March 2016

Published 15 April 2016 Volume 2016:9 Pages 47—58

DOI https://doi.org/10.2147/IDR.S99046

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Rekha Dhanwani

Peer reviewer comments 2

Editor who approved publication: Professor Suresh Antony

Armando Gonzalez-Ruiz,1 R Andrew Seaton,2 Kamal Hamed3

1Darent Valley Hospital, Dartford, UK; 2Queen Elizabeth University Hospital, Glasgow, UK; 3Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA

Abstract: Infections caused by Gram-positive pathogens remain a major public health burden and are associated with high morbidity and mortality. Increasing rates of infection with Gram-positive bacteria and the emergence of resistance to commonly used antibiotics have led to the need for novel antibiotics. Daptomycin, a cyclic lipopeptide with rapid bactericidal activity against a wide range of Gram-positive bacteria including methicillin-resistant Staphylococcus aureus, has been shown to be effective and has a good safety profile for the approved indications of complicated skin and soft tissue infections (4 mg/kg/day), right-sided infective endocarditis caused by S. aureus, and bacteremia associated with complicated skin and soft tissue infections or right-sided infective endocarditis (6 mg/kg/day). Based on its pharmacokinetic profile and concentration-dependent bactericidal activity, high-dose (>6 mg/kg/day) daptomycin is considered an important treatment option in the management of various difficult-to-treat Gram-positive infections. Although daptomycin resistance has been documented, it remains uncommon despite the increasing use of daptomycin. To enhance activity and to minimize resistance, daptomycin in combination with other antibiotics has also been explored and found to be beneficial in certain severe infections. The availability of daptomycin via a 2-minute intravenous bolus facilitates its outpatient administration, providing an opportunity to reduce risk of health care-associated infections, improve patient satisfaction, and minimize health care costs. Daptomycin, not currently approved for use in the pediatric population, has been shown to be widely used for treating Gram-positive infections in children.

Keywords: daptomycin, efficacy, Gram-positive infections, high dose, OPAT, safety

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