Abstract
The pharmacokinetics and pharmacodynamics of daptomycin have been extensively explored in a host of in vitro models, multiple different patient populations, and clinical studies. Daptomycin exhibits concentration-dependent bactericidal activity with the ratio of unbound area-under-the-curve to minimum inhibitory concentration (fAUC/MIC) best predicting antibacterial efficacy in vitro. The large body of evidence suggests that higher doses (e.g., 8–10 mg/kg) of daptomycin are more effective and equally safe and should be used for specific pathogens (i.e., methicillin-resistant Staphylococcus aureus, Enterococcus) and in certain patient scenarios (i.e., critically ill, bacteremia, endocarditis). The emergence of resistance to daptomycin during therapy and clinical failure in serious infections brings its efficacy as monotherapy into question while the ease of administration, dosing schedule, and lack of nephrotoxicity continues to drive its use until more reliable therapeutic alternatives for gram-positive infections are established.
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Wenzler, E., Liao, S., Rodvold, K.A. (2016). Pharmacodynamics of Daptomycin. In: Rotschafer, J., Andes, D., Rodvold, K. (eds) Antibiotic Pharmacodynamics. Methods in Pharmacology and Toxicology. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-3323-5_13
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