Cyclic lipopeptide antibiotic
ATC code: J01XX09 (Daptomycin)
Brand names
Cubicin, Daptomicina Accord, Daptomicina Hospira, Daptomicina Mylan
Daptomycin binds the cytoplasmic membrane of gram-positive bacteria in the presence of calcium – forms transmembrane channels, causes rapid membrane depolarization and cell death without lysis. Bactericidal activity is concentration-dependent. Active against S. aureus (including MRSA), S. pyogenes, Enterococcus faecalis and faecium (including VRE), and coagulase-negative staphylococci. Inactivated by pulmonary surfactant – ineffective in pneumonia.
Second line
Complicated skin and soft tissue infections in adults, including confirmed MRSA. Per 2014 and SEIMC 2023 – alternative to vancomycin in intolerance, with MRSA MIC ≥1.5 mg/L, or with no response to vancomycin at 72 hours. Dose: 4 mg/kg IV once daily for 7-14 days. With severe renal impairment (CrCl <30) extend interval to 48 hours. Use empirically only after cultures.
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Use only when no alternative exists. Limited pregnancy experience; in severe staphylococcal infections occasionally used – jointly with infectious disease and obstetrics.
Not recommended. Milk excretion data are limited. Interrupt breastfeeding for the course or switch the infant to formula.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Daptomycin is evaluated for the following indications with varying evidence strength: Complicated skin and soft tissue infection (evidence tier A). See the full indication matrix with dosing and citations above on this page.
Common side effects of Daptomycin (≥ 1 in 100): Elevated CK, Injection-site reactions, Nausea, diarrhea, Headache, Transaminase elevation. See the Safety section for uncommon and serious reactions.
FDA category B. Use only when no alternative exists. Limited pregnancy experience; in severe staphylococcal infections occasionally used – jointly with infectious disease and obstetrics.
Not recommended. Milk excretion data are limited. Interrupt breastfeeding for the course or switch the infant to formula.
Daptomycin is contraindicated in: Hypersensitivity to daptomycin; Pregnancy and breastfeeding; Pneumonia as the sole diagnosis (daptomycin is inactive in lungs). Full list in the Safety section.