Daptomycin: pharmacology and clinical use.
BACKGROUND
Infections caused by Gram-positive organisms have increased in frequency and severity. Daptomycin offers a therapeutic option in an era of increasing resistance.


METHODS
Literature from 1986 to present was reviewed for pharmacological, preclinical and clinical studies on daptomycin.


RESULTS
The pharmacological properties, resistance mechanisms and clinical applications of daptomycin are discussed. Recommendations are offered on the use of this agent for the treatment of resistant Gram-positive infections.


CONCLUSIONS
Daptomycin is a reliable agent for the treatment of Gram-positive infections. It has been shown to be effective in bacteremia and endocarditis, as well as in soft-tissue infections caused by Gram-positive organisms. Its role in the treatment of bone and joint infections is not well-defined. Resistance is currently uncommon in clinical isolates. However, emergence of resistance during therapy is a concern. This may be prevented by use of higher doses.
Kosmidis
Christos
C
Wayne State University, Department of Medicine, University Health Center, Suite 5C, 4201 St. Antoine, Detroit, MI 48201, USA. dlevine@med.wayne.edu
Levine
Donald P
DP
D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D017576:Daptomycin / Q000494:pharmacology* / Q000627:therapeutic use*; D004353:Drug Evaluation, Preclinical; D006094:Gram-Positive Bacteria / Q000187:drug effects / Q000502:physiology; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D020713:Vancomycin Resistance / Q000187:drug effects / Q000502:physiology
D000900:Anti-Bacterial Agents; D017576:Daptomycin