Daptomycin is an antibiotic intended for complicated skin and skin structure snfections (cSSSI). There are many other applications in which daptomycin may prove useful; for example, daptomycin is also prescribed for certain bloodstream infections.
As a potent antibiotic, it wipes out and prevents the growth of bacteria. However, this treatment has zero effect on treating viral infections, such as the common cold or flu. In order to prevent antibacterial resistance, doctors will test the patient to determine if this treatment is appropriate. Daptomycin is proven to kill various streptococcus strains of bacteria, including streptococcus pyogenes, streptococcus agalactiae and streptococcus dysgalactiae subspecies equisimilis, as well as staphylococcus aureus and enterococcus faecalis.
Daptomycin is produced by fermenting streptomyces roseosporus, sourced predominantly from soils. It is considered to be a highly effective cyclic lipopeptide antibacterial agent that can stop and prevent the growth of the aforementioned strains of bacteria. It quickly attaches itself to predetermined bacterial membranes and effectively annihilates the possibility of growth.
Daptomycin also goes by the US trade name Cubicin and it is only available on prescription by a certified physician. A trained nurse administers treatment at all times in a hospital or clinical facility through the intravenous route, or a needle placed in the veins.
A number of side effects have been reported in patients who have undergone treatment with daptomycin.
The dosage amounts for daptomycin vary from one patient to another. Generally speaking, however, this is dependent on a range of factors, including:
4 mg infused over 30-60 minutes for 7-14 days
6 mg infused over 30-60 minutes for two to six weeks
The intravenous route of application is sometimes administered as a 30 minute treatment, depending on the patient. The FDA warns against dosing pediatric patients in two minute timeframes, as this could increase the risks of serious adverse effects.
Altered doses may furthermore be required in certain high-risk groups that are more predisposed to developing complications from the treatment.
The instructions for reconstituting daptomycin are dependent on the strength and model of the medicine. Daptomycin may be supplied in three different formats of lyophilized powder indicated for reconstitution. These include:
Instructions for reconstituting Cubicin
1. Mix one vial with 10 ml of 0.9% NaCl (sodium chloride).
2. Shake, but do not over mix, as this causes foaming. Rotate back and forth in a non-aggressive motion.
3. Rest by allowing the solution to be left as is for roughly 10 minutes.
4. Transfer to the needle. 21 gauge needles or smaller varieties are recommended for transfer.
1. Mix in the supplied vial. Unlike Cubincin, which uses 0.9% NaCl during reconstitution, this hybrid should only be mixed with sterile water reserved for intravenous applications. Additionally, bacteriostatic water may also be used. The indicated amount of sterile water or bacteriostatic water for reconstitution with Cubincin RF is 10 ml.
2. Rotate and use a gentle motion to mix the solution - watch for even distribution. If discolorations or particles are observed, check with a supervisor before use.
3. Transfer by using a 21 gauge needle or a smaller variety.
1. Mix 7 mL of 0.9% NaCl (sodium chloride) into the vial.
2. Dilute and leave the diluted mix for roughly 10 minutes. This means that you should let it sit undisturbed before mixing.
3. Swirl and use a gentle motion to reconstitute the mix.
4. Transfer to the needle. As with both Cubincin and Cubincin RF, a 21 gauge needle or smaller hybrid should be used to complete the transfer.
Negative adverse effects have been reported when daptomycin is used in conjunction with certain other medications. A few are outlined below, but this is not an all inclusive list. Doctors generally investigate patient's medical history before commencing treatment with any medication, so patients are advised to disclose their full medical background, including past allergies, current medicines, lifestyle habits, underlying ailments and more.
The most commonly reported negative drug interactions with daptomycin include:
In the event that concomitant use is necessary, a modified dose may be required.
Inform your medical provider if you're currently using any medicine, including over the counter drugs, such as herbal supplements and vitamins.
This drug should not be given to patients who have recently received the cholera vaccine, as serious negative interactions can result from concomitant use.
The presence of certain pre-existing conditions can cause complications to arise. Tell your doctor if you have been diagnosed with:
In these cases, an adjusted dosage may be required in order to prevent the condition or conditions from becoming worse.
In rare cases, eosinophilic pneumonia may develop following daptomycin treatments. This is a serious condition that requires immediate medical intervention. Some of the main warning signs of eosinophilic pneumonia include:
There is also a risk of developing peripheral neuropathy with daptomycin treatments. The warning signs include:
If these symptoms are noticed, consult your doctor right away.
Patients who have existing peripheral neuropathies and myopathy disorders should be monitored closely. To reduce the risks of side effects, physicians may order statin treatments during the infusion process while monitoring renal function.
In some patients, the response to this treatment may be poor. If your symptoms persist or get worse even after treatment, contact your healthcare provider. Blood cultures can be taken to determine if the infection is reoccurring and whether an alternate treatment is required.
As a general rule of thumb, if you do not feel better within a few days of treatment, consult your medical provider right away.
One complication that is often reported with intravenous antibiotic treatments is persistent diarrhea, which could happen well past the treatment date. Patients could develop this discomforting condition two months or more after the initial treatment with daptomycin. In the event this occurs, patients are advised to avoid taking over the counter medicines and contact a medical provider.
Special note: The development of diarrhea post-treatment is classified as clostridium difficile-associated diarrhea (CDAD), which can be fatal if left as is. It is, therefore, important to seek medical help if you suspect CDAD. In order to treat this condition, doctors may use a number of combination treatments, including:
Due to these risks, doctors generally complete an overview of risks versus benefits before commencing treatment with daptomycin.
Daptomycin could possibly affect the results of certain medical tests. If you have an upcoming appointment scheduled with a healthcare facility, inform medical workers about recent daptomycin use.
Daptomycin is considered safe for use in children over the age of one. Based on clinical trials, this medicine can affect the following areas of development and function in neonates or infants younger than 12 months old:
Indications for use ' daptomycin is a potent antibiotic. However, it is not intended for certain conditions, including:
In clinical trials, the outcomes for use in these respects proved to be unfavorable.
The storage instructions vary depending on whether the vial is sealed or reconstituted.
As a general rule of thumb, unopened vials should be stored at the following temperatures to maintain quality and efficacy:
Note: In all cases, the unopened vials should never be kept in areas of excessive heat. Doing so could result in the risk of killing the antibacterial agent.
The storage instructions for storing reconstituted solutions are also based on the formation of daptomycin:
Daptomycin is an antibacterial agent intended for treating complicated skin and skin structure infections, as well as right-sided infective endocarditis. It is otherwise known as a cyclic lipopeptide antibacterial agent that is approved for use in adults and children over the age of one years old.
To reduce incidences of antibiotic resistance, medical researchers suggest only prescribing daptomycin for strains of bacteria that have proven to be responsive to the treatment. To help determine this, skin or soft tissue tests are performed for patients suspected of having a cSSSI.
Generally speaking, the medicine is administered by a nurse in a hospital setting. Daptomycin permeates the bloodstream through intravenous injections, which take place over the course of 30 - 60 minutes. There are some exceptions, however, where infusion happens as quickly in two minutes or less.
Daptomycin is usually well-tolerated by most patients and boasts a high success rating based on clinical trials. Nevertheless, complications may arise from using this medicine, including anaphylactic shock, chronic diarrhea and antibiotic resistance. Patients should pay attention to precautions outlined by a healthcare provider and know when to call 911.