DefinitionThis section has been translated automatically.
Antibiotic from the class of cyclic lipopeptides with bactericidal activity, especially against gram-positive pathogens. Reserve antibiotic for infections with multi-resistant Gram-positive pathogens (e.g. MRSA, vancomycin-resistant enterococci [VRE]). The penetration into the lung is comparatively poor, so that only low concentrations of the active substance are reached in the lung. Daptomycin is therefore not suitable for the treatment of patients with pneumonia. The elimination of the active substance is mainly renal!
Pharmacodynamics (Effect)This section has been translated automatically.
Daptomycin is a cyclic lipopeptide which penetrates the bacterial cytoplasmic membrane via a lipid side chain and forms pores (ion channels) in the presence of calcium, which lead to potassium outflow, membrane depolarization and thus to rapid bactericide.
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Spectrum of actionThis section has been translated automatically.
The spectrum of action is limited to Gram-positive pathogens (streptococci, enterococci and staphylococci) including MRSA, VRSA and VRE. S.a.u. multiresistance.
IndicationThis section has been translated automatically.
- Approved in adults for the treatment of complicated skin and soft tissue infections (e.g. postoperative wound infections, superinfections in burns and abscesses).
- Also approved for the treatment of right-sided infective endocarditis due to Staphylococcus aureus infections.
- Use also in mixed infections where Gram-negative and/or certain anaerobic bacteria are suspected, in combination with suitable antibacterial agents effective against anaerobes according to the antibiogram.
Pregnancy/nursing periodThis section has been translated automatically.
Do not use in pregnant women (insufficient data available) unless medically indicated (positive risk-benefit assessment). Do not use while breast-feeding (insufficient data).
Dosage and method of useThis section has been translated automatically.
- Complicated skin and soft tissue infections without concurrent Staphylococcus aureus bacteremia: 1 time/day 4 mg/kg bw i.v. (over 30 minutes) for 7-14 days or until infection resolves.
- Complicated skin and soft tissue infections with concurrent Staphylococcus aureus bacteremia: 1 time/day 6 mg/kg bw i.v. (over 30 minutes) for 7-14 days or longer if needed.
- Known or suspected right-sided infective endocarditis due to Staphylococcus aureus: 1 time/day 6 mg/kg bw i.v. (over 30 minutes).
Notice. Dose adjustment in advanced renal insufficiency is required (GFR < 80 ml/min)!
Undesirable effectsThis section has been translated automatically.
Common: drug exanthema, myopathies (muscle pain, muscle sensitivity, muscle weakness or muscle cramps) and CK increase, renal insufficiency, nausea, vomiting, diarrhea, mycoses.
PreparationsThis section has been translated automatically.
Cubicin
LiteratureThis section has been translated automatically.
- Breen JO (2010) Skin and soft tissue infections in immunocompetent patients. On Fam Physician 81: 893-899
- Chamberlain RS et al (2009) Daptomycin for the treatment of surgical site infections. Surgery. 146: 316-324
- Draenert R, Bogner JR (2009) New antibiotics: small or big advances? Internist (Berl) 50: 1282, 1284-1288
- Friedman BC et al (2010) A retrospective review of clinical experience with daptomycin for a variety of wound types in a burn and wound care facility. South Med J 103: 748-752
- Kinney KK (2010) Treatment of infections caused by antimicrobial-resistant gram-positive bacteria. On J Med Sci 340: 209-217
- Siegman-Igra Y, Talan DA (2006) Therapy for methicillin-resistant Staphylococcus aureus. N Engl J Med 355: 2153
Prof. Dr. med. Peter Altmeyer