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Daptomycin: the first approved lipopeptide antimicrobial
1Institute for the Study of Geriatric Pharmacotherapy, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA. guayxoo1@umn.edu
Summary
Daptomycin, a novel lipopeptide antimicrobial, effectively treats resistant gram-positive infections. Careful monitoring for myotoxicity and judicious use against multiresistant pathogens are essential for preserving its efficacy.
Area of Science:
- Pharmacology
- Infectious Diseases
- Microbiology
Background:
- Daptomycin is the first Food and Drug Administration-approved lipopeptide antimicrobial.
- Its mechanism of action involves altering cell membrane electrical charge, differing from peptidoglycan synthesis inhibition.
Purpose of the Study:
- To review the literature on daptomycin, the first marketed lipopeptide antimicrobial.
- To evaluate its efficacy, safety, and optimal use against resistant pathogens.
Main Methods:
- Conducted a PUBMED search for English-language articles (1985-2003).
- Reviewed abstracts from the Interscience Conference on Antimicrobial Agents and Chemotherapy (1985-2003).
- Included all studies evaluating any aspect of daptomycin.
Main Results:
- Daptomycin shows broad-spectrum activity against gram-positive aerobes and anaerobes, including resistant strains.
- Demonstrated efficacy in complicated skin and skin-structure infections, but not pneumonia.
- The primary adverse event is rare myotoxicity; approved dose is 4 mg/kg daily.
Conclusions:
- Daptomycin is valuable against multiresistant gram-positive pathogens.
- Should be reserved for infections where alternative agents are unsuitable.
- Requires careful monitoring for myotoxicity and prospective surveillance of bacterial sensitivities.