title: Daptomycin use in pediatric patients.
abstract: OBJECTIVE
  Currently available evidence on the use of daptomycin in pediatric patients is reviewed and evaluated.
  
  
  CONCLUSIONS
  Although guidelines on the treatment of methicillin-resistant Staphylococcus aureus infections recommend daptomycin for use in pediatric patients, that recommendation is primarily based on expert opinion. A literature search for articles on pediatric daptomycin use identified three pharmacokinetic studies, three case reports, and one retrospective review. The limited body of published evidence indicates that pediatric patients may require higher daptomycin doses than adult patients in order to attain therapeutic serum concentrations. Pharmacokinetic studies in pediatric patients demonstrated faster daptomycin clearance (CL) and a decreased area under the concentration-time curve (AUC) relative to values reported in adults. Daptomycin appears to have a shorter half-life in patients 2-6 years of age relative to those 12-17 years of age. A retrospective review of 16 cases in which pediatric patients were treated with daptomycin for invasive gram-positive infections indicated positive outcomes after the addition of daptomycin to standard therapy. Overall, daptomycin appears to be well tolerated in pediatric patients.
  
  
  CONCLUSIONS
  Due to the limited nature of the available literature, use of daptomycin in pediatric patients should be limited to situations in which other options are not viable due to toxicity, local susceptibility patterns, or likely treatment failure. As a result of faster drug CL and lower AUC values, higher doses may be necessary in pediatric patients to achieve serum concentrations similar to those seen with adult dosing.
authors: Cheryl Durand, Pharm.D., is Assistant Professor of Pharmacy Practice; Andrew Brueckner is a Pharm.D. candidate; Chelsea Sampadian is a Pharm.D. candidate; Kristine C. Willett, Pharm.D., is Associate Professor of Pharmacy Practice; and Paul Belliveau, Pharm.D., is Professor of Pharmacy Practice, School of Pharmacy-Worcester/Manchester, MCPHS University, Manchester, NH. cheryl.durand@mcphs.edu.
authors: Cheryl
authors: C
authors: Durand
authors: Cheryl Durand, Pharm.D., is Assistant Professor of Pharmacy Practice; Andrew Brueckner is a Pharm.D. candidate; Chelsea Sampadian is a Pharm.D. candidate; Kristine C. Willett, Pharm.D., is Associate Professor of Pharmacy Practice; and Paul Belliveau, Pharm.D., is Professor of Pharmacy Practice, School of Pharmacy-Worcester/Manchester, MCPHS University, Manchester, NH.
authors: Andrew
authors: A
authors: Brueckner
authors: Cheryl Durand, Pharm.D., is Assistant Professor of Pharmacy Practice; Andrew Brueckner is a Pharm.D. candidate; Chelsea Sampadian is a Pharm.D. candidate; Kristine C. Willett, Pharm.D., is Associate Professor of Pharmacy Practice; and Paul Belliveau, Pharm.D., is Professor of Pharmacy Practice, School of Pharmacy-Worcester/Manchester, MCPHS University, Manchester, NH.
authors: Chelsea
authors: C
authors: Sampadian
authors: Cheryl Durand, Pharm.D., is Assistant Professor of Pharmacy Practice; Andrew Brueckner is a Pharm.D. candidate; Chelsea Sampadian is a Pharm.D. candidate; Kristine C. Willett, Pharm.D., is Associate Professor of Pharmacy Practice; and Paul Belliveau, Pharm.D., is Professor of Pharmacy Practice, School of Pharmacy-Worcester/Manchester, MCPHS University, Manchester, NH.
authors: Kristine C
authors: KC
authors: Willett
authors: Cheryl Durand, Pharm.D., is Assistant Professor of Pharmacy Practice; Andrew Brueckner is a Pharm.D. candidate; Chelsea Sampadian is a Pharm.D. candidate; Kristine C. Willett, Pharm.D., is Associate Professor of Pharmacy Practice; and Paul Belliveau, Pharm.D., is Professor of Pharmacy Practice, School of Pharmacy-Worcester/Manchester, MCPHS University, Manchester, NH.
authors: Paul
authors: P
authors: Belliveau
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D019540:Area Under Curve; D002648:Child; D002675:Child, Preschool; D017576:Daptomycin / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D006207:Half-Life; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D017576:Daptomycin