Infection of skin AND/OR subcutaneous tissue, Complicated
a) The usual intravenous dose of daptomycin for complicated skin and skin structure infections is 4 milligrams/kilogram once every 24 hours for 7 to 14 days. Daptomycin should not be dosed more frequently than once a day due to more frequent elevations in creatine phosphokinase (Prod Info CUBICIN(R) IV injection, 2006).
Staphylococcus aureus bacteremia, including right-sided endocarditis
a) The intravenous dose of daptomycin for Staphylococcus aureus bacteremia is 6 milligrams/kilogram every 24 hours for a minimum of 2 to 6 weeks. Daptomycin should not be dosed more frequently than once a day due to more frequent elevations in creatine phosphokinase (Prod Info CUBICIN(R) IV injection, 2006).
A) In patients with a creatinine clearance greater than or equal to 30 milliliters/minute (mL/min), the recommended daptomycin dosages are 4 milligrams/kilogram (mg/kg) (complicated skin and skin structure infections) or 6 mg/kg (S. aureus bloodstream infections) once every 24 hours. In patients with a creatinine clearance less than 30 mL/min (including patients receiving hemodialysis or continuous ambulatory peritoneal dialysis), the recommended daptomycin dosages are 4 mg/kg (complicated skin and skin structure infections) or 6 mg/kg (S. aureus bloodstream infection) once every 48 hours (Prod Info CUBICIN(R) IV injection, 2006).
B) At least half of an intravenous dose is excreted unchanged in the urine (Woodworth et al, 1994a).
C) In one bacteremic patient (Leuconostoc mesenteroides) with renal impairment (creatinine clearance, 55 milliliters/minute (mL/min)), a 400-milligram (mg) loading dose followed by 4.5 mg/kilogram (kg) every 36 hours was given until recovery of renal function; at that time (day 9), the dose was increased to 6 mg/kg once daily (Golan et al, 2001a).
