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Peptide

Daptomycin

Intravenous hospital antibiotic against resistant gram-positive bacteria, such as MRSA. Used in complicated skin infections and in S. aureus bacteremia and endocarditis.
Regulatory status
Approved (FDA / EMA)
Family
Cyclic lipopeptide antibiotic
Scientific evidence
High
Number of findings
1
Where it acts
Immunity and defense · Heart and blood
Also known as
daptomycin, Cubicin, Cubicin RF

Regulatory status

FDA (U.S.): Approved (2003, Cubicin) for complicated skin infections; in 2006 it was extended to S. aureus bacteremia, including right-sided endocarditis.

EMA (EU): Approved (2006, Cubicin) for complicated skin infections, right-sided endocarditis and S. aureus bacteremia.

Dose

4 mg/kg IV daily in skin infections and 6 mg/kg IV daily in bacteremia/endocarditis, adjusting if there is renal impairment (FDA/EMA label).

Safety

It can damage muscle (CPK rise, pain, weakness, rarely rhabdomyolysis): CPK is monitored weekly. It can cause eosinophilic pneumonia, neuropathy, and rare severe skin reactions. Hospital use.

Interactions

Statins increase muscle risk; it is usually recommended to stop them during treatment. It can falsify some coagulation tests (PT/INR).

Effect by goal · level of evidence

S. aureus bacteremia and endocarditis

improves High RCT (AA) in people
11% vs 26% kidney damage

Trial with 246 patients. Daptomycin 6 mg/kg/day achieved a success at 42 days similar to standard treatment (44.2% vs 41.7%) and caused less kidney damage (11% vs 26.3%).

View the study (RCT) →

In depth

Where it acts

Immunity and defense, Heart and blood

Defenses and infections

How it works

It inserts into the bacterial membrane in a calcium-dependent manner, depolarizes it and the bacterium dies rapidly. It is not useful for pneumonia because pulmonary surfactant inactivates it.

What the evidence says

In people

  • S. aureus bacteremia and endocarditis. Trial with 246 patients. Daptomycin 6 mg/kg/day achieved a success rate at 42 days similar to standard treatment (44.2% versus 41.7%) and caused less kidney damage (11% versus 26.3%). PubMed 16914701

References

  1. PubMed 16914701

Information, not medical advice. Prescription or unapproved peptides should only be used under medical supervision.

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