High-Dose Daptomycin and Clinical Applications
| Autor: | William J. Olney, Ah Hyun Jun, Timothy W Jones, Jessica L. Michal |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Methicillin-Resistant Staphylococcus aureus
0303 health sciences medicine.medical_specialty 030306 microbiology business.industry MEDLINE Bacteremia Staphylococcal Infections Article Anti-Bacterial Agents 03 medical and health sciences 0302 clinical medicine Search terms Pharmacotherapy Daptomycin Vancomycin Internal medicine medicine Humans Pharmacology (medical) 030212 general & internal medicine business Retrospective Studies medicine.drug |
| Zdroj: | Ann Pharmacother |
| ISSN: | 1542-6270 1060-0280 |
| Popis: | Objective: To evaluate evidence for high-dose daptomycin (doses ≥ 8 mg/kg/d). Data Sources: A PubMed/MEDLINE literature search was performed (January 2000 to December 2020) using the search terms daptomycin, high dose, and dosing. Review article references and society guidelines were reviewed. Study Selection and Data Extraction: Clinical trials, observational studies, retrospective studies, meta-analyses, and systematic reviews reporting on high-dose daptomycin were included. Data Synthesis: Experimentally, daptomycin outperforms other antimicrobials for high inoculum and biofilm-associated infections. Clinically, high-dose daptomycin is supported as salvage and first-line therapy for endocarditis and bacteremia, primarily when caused by methicillin-resistant Staphylococcus aureus (when vancomycin minimum inhibitory concentration is >1 mg/L) and Enterococcus. High-dose daptomycin appears effective for osteomyelitis and central nervous system infections, although comparative studies are lacking. High dosing in renal replacement therapy requires considering clearance modality to achieve exposures like normal renal function. Weight-based dosing in obesity draws concern for elevated exposures, although high doses have not been evaluated kinetically in obesity. Some data show benefits of high doses in overweight populations. Burn patients clear daptomycin more rapidly, and high doses may only achieve drug exposures similar to standard doses (6 mg/kg). Relevance to Patient Care and Clinical Practice: This review analyzes the efficacy and safety of high-dose daptomycin in serious gram-positive infections. Discussion of specific infectious etiologies and patient populations should encourage clinicians to evaluate their daptomycin dosing standards. Conclusions: The efficacy of high-dose daptomycin and limited safety concerns encourage clinicians to consider high-dose daptomycin more liberally in severe gram-positive infections. |
| Databáze: | OpenAIRE |
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