title: Daptomycin: evaluation of a high-dose treatment strategy.
abstract: With a decreasing pipeline of novel antibiotics and increasing antibacterial resistance, the need to optimise the current antibiotics in our armamentarium has become vitally important. Daptomycin is a novel lipopeptide antibiotic that exhibits concentration-dependent activity. Currently, the daptomycin dosage is 4 mg/kg/day for treatment of complicated skin and soft-tissue infections and 6 mg/kg/day for Staphylococcus aureus bloodstream infections, including those with right-sided endocarditis, however higher doses (>6 mg/kg/day) have been explored as a possible alternative. A comprehensive review of published data identified through a MEDLINE search of the literature from 1967-2011 and a manual search of references was performed with the primary objective of critically evaluating the safety and efficacy of high-dose daptomycin. Search results yielded two prospective trials, three retrospective reviews, case reports and in vitro simulation studies on high-dose daptomycin. To date, clinical trials, retrospective reviews, case reports and in vitro simulation models have documented the safety and tolerability of high-dose daptomycin, even when administered for a prolonged duration. Additionally, in vitro benefits observed include suppression of the emergence of daptomycin resistance and increased rapidity of bactericidal activity.
authors.affiliation: New York Methodist Hospital, Department of Pharmacy, Brooklyn, NY 11215, USA. gary.wu2@gmail.com
authors.forename: Gary
authors.initials: G
authors.lastname: Wu
authors.forename: Teena
authors.initials: T
authors.lastname: Abraham
authors.forename: Jonathan
authors.initials: J
authors.lastname: Rapp
authors.forename: Fabienne
authors.initials: F
authors.lastname: Vastey
authors.forename: Nasser
authors.initials: N
authors.lastname: Saad
authors.forename: Eric
authors.initials: E
authors.lastname: Balmir
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016470:Bacteremia / Q000188:drug therapy; D001424:Bacterial Infections / Q000188:drug therapy*; D017576:Daptomycin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D017192:Skin Diseases, Bacterial / Q000188:drug therapy; D018461:Soft Tissue Infections / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D017576:Daptomycin