title: Safety of daptomycin in patients receiving hemodialysis.
abstract: OBJECTIVE
  To determine the safety of daptomycin administered using a variety of doses and dosing frequencies in patients receiving intermittent hemodialysis who had probable or confirmed gram-positive infections.
  
  
  METHODS
  Analysis of data from the Cubicin Outcomes Registry and Experience (CORE), a multicenter, retrospective, observational registry.
  
  
  METHODS
  Fifty-four study sites, mostly (46%) large teaching hospitals.
  
  
  METHODS
  Three hundred ninety-three adults in the CORE registry who received intermittent hemodialysis between 2005 and 2008.
  
  
  RESULTS
  The CORE registry is noninterventional and collects standard-of-care data on daptomycin treatment from health care institutions. Of the 393 patients, 370 (94%) could be categorized by daptomycin dosing frequency: every 48 hours (251 patients [64%]), 3 times/week (87 [22%]), and every 24 hours (32 [8%]); the remaining 23 (6%) had unreported dosing frequencies or received a single dose of daptomycin. Three hundred eighty-four patients (98%) received part of their daptomycin therapy as an inpatient and 129 patients (33%) received part of their daptomycin therapy in an intensive care setting. The primary infection type was bacteremia (224 patients [57%]), and the most common pathogen was Staphylococcus aureus (155 patients [39%]). Thirty-eight adverse events possibly related to daptomycin occurred in 28 patients (7%); increased blood creatine kinase level (7 patients [1.8%]) was the most common adverse event. Adverse-event rates were similar across all dosing regimens.
  
  
  CONCLUSIONS
  In these patients undergoing hemodialysis, daptomycin was a well-tolerated treatment for gram-positive infections across several doses and dosing frequencies. Further study in prospective trials is warranted.
authors.affiliation: College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Mueller
authors.forename: Jason A
authors.initials: JA
authors.lastname: Crompton
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Donovan
authors.forename: Sara
authors.initials: S
authors.lastname: Yankalev
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Lamp
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D003402:Creatine Kinase / Q000097:blood / Q000187:drug effects; D017576:Daptomycin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D006435:Renal Dialysis; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D003402:Creatine Kinase; D017576:Daptomycin