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daptomycin (Cubicin)

Tradename: Cubicin (New agent 2003) Indications: - bacterial infections due to susceptible organisms a) complicated skin infections* due to gram positive bacteria including methicillin-resistant Staphylococcus aureus (MRSA) b) Staphylococcus aureus bacteremia, sepsis c) endocarditis, including right sided endocarditis caused by MSSA & MRSA d) investigational: vancomycin-resistant enterococci (VRE) * works about as well as vancomycin, oxacillin or nafcillin for treating complicated skin infections Contraindications: - bound by pulmonary surfactant, thus not effective in treatment of staphylococcal pneumonia [5] Dosage: - IV, QD dosing. 6 mg/kg/day {$135/vial} * Cubicin & Cubicin RF reconstituted from powder differently - sodium chloride solution for Cubicin - either sterile or bacteriostatic water for injection for Cubicin RF - storage different as well (see instructions) Monitor: serum creatinine & serum creatine kinase weekly during treatment Adverse effects: 1) myopathy, increased serum CK (25%) 2) peripheral neuropathy (10%) [2] 3) resistance develops in 1/3 of patients with persistently positive cultures [2] 4) risk of eosinophilic pneumonia [4] Drug interactions: - possible increased risk of myopathy when used in combination with statin (consider temporarily discontinuing statin) Mechanism of action: 1) cyclic lipopeptide 2) depolarizes bacterial cell membrane

Interactions

drug interactions

General

lipopeptide other antibiotic

Properties

COMPARTMENT: membrane MOTIF: binding site FOR-BINDING-OF: lipid MISC-INFO: elimination route LIVER

Database Correlations

PUBCHEM correlations

References

  1. Prescriber's Letter 10(11):63 2003
  2. Fowler VG Jr et al, Daptomycin versus standard therapy for bacteremia and endocarditis caused by Staphylococcus aureus. N Engl J Med 2006, 355:653 PMID: 16914701 - Grayson ML The treatment triangle for staphylococcal infections N Engl J Med 2006, 355:724 PMID: 16914709
  3. Arbeit RD et al, The safety and efficacy of daptomycin for the treatment of complicated skin and skin-structure infections. Clin Infect Dis 2004, 38:1673 PMID: 15227611
  4. FDA MedWatch, 07/29/2010 Cubicin (daptomycin): Drug Safety Communication - Risk of Eosinophilic Pneumonia http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm220499.htm
  5. Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18. American College of Physicians, Philadelphia 2012, 2015, 2018.
  6. Lowes R New FDA Watch List Flags More Drugs Medscape Internal Medicine. July 3, 2017 http://www.medscape.com/viewarticle/882425
  7. Cervera C, Sanroma P, Gonzalez-Ramallo V et al Safety and efficacy of daptomycin in outpatient parenteral antimicrobial therapy: a prospective and multicenter cohort study (DAPTODOM trial). Infect Dis (Lond). 2017 Mar;49(3):200-207. PMID: 27820968