title: Successful Treatment of a Pacemaker Infection with Intraperitoneal Daptomycin.
abstract: We investigated the pharmacokinetics of intraperitoneal administration of daptomcyin in a peritoneal dialysis (PD) patient treated for a pacemaker infection with Staphylococcus epidermidis. After initial start of intravenous daptomycin at 9 mg/kg body weight every 48 hours, the therapy was switched to intraperitoneal administration of 5.3 mg/kg body weight in 1 L icodextrin 7.5% with a dwell time of 12 hours overnight every 48 hours. Therapeutic drug monitoring (TDM) was performed at 4 hours and 24 hours after dose administration. Due to high peak concentration above target peak concentration, the dose was reduced to a final maintenance dose of 3.2 mg/kg body weight. Data from this single case suggest that serum drug concentration above the minimal inhibitory concentration (MIC) can be easily achieved with intraperitoneal administration of daptomycin every 48 hours even with a lower dose, as recommended for the intravenous administration, but measurement of serum concentration and dose adjustments are mandatory in such cases.
authors.affiliation: Division of Clinical Pharmacology and Toxicology, University Hospital Basel, Basel, Switzerland.
authors.forename: Anne B
authors.initials: AB
authors.lastname: Taegtmeyer
authors.affiliation: Clinic for Transplant Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.
authors.forename: Nina
authors.initials: N
authors.lastname: Kononowa
authors.affiliation: Clinic for Infectious Diseases, University Hospital Basel, Basel, Switzerland.
authors.forename: Dominique
authors.initials: D
authors.lastname: Fasel
authors.affiliation: Division of Clinical Pharmacology and Toxicology, University Hospital Basel, Basel, Switzerland Department of Biomedicine, University of Basel, Basel, Switzerland.
authors.forename: Manuel
authors.initials: M
authors.lastname: Haschke
authors.affiliation: Clinic for Transplant Immunology and Nephrology, University Hospital Basel, Basel, Switzerland felix.burkhalter@usb.ch.
authors.forename: Felix
authors.initials: F
authors.lastname: Burkhalter
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017576:Daptomycin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D010530:Peritoneal Dialysis; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000209:etiology*; D012074:Remission Induction; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000209:etiology*; D013212:Staphylococcus epidermidis
chemical_list: D000900:Anti-Bacterial Agents; D017576:Daptomycin
keywords: Intraperitoneal; daptomycin; peritoneal dialysis
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