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Daptomycin use in a neonate: serum level monitoring and outcome

Kosmas Sarafidis1, Elias Iosifidis, Evangelos Gikas

  • 11st Department of Neonatology, Aristotle University, Hippokration General Hospital, Thessaloniki, Greece.

American Journal of Perinatology
|December 17, 2009
PubMed

Insights

This study shows successful treatment of persistent Gram-positive bacteremia in a preterm infant using higher daptomycin doses. The infant tolerated the treatment well, indicating potential for this dosing in neonates.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Persistent bacteremia in preterm neonates poses significant treatment challenges.
  • Gram-positive bacterial infections are a common cause of neonatal sepsis.
  • Limited data exists on daptomycin use in preterm infants.

Observation:

  • A preterm neonate presented with persistent bacteremia caused by Gram-positive bacteria.
  • Daptomycin was administered at 6 mg/kg every 12 hours, exceeding standard adult dosing.
  • No adverse events were observed during the treatment course.

Findings:

  • Successful eradication of bacteremia was achieved with the higher daptomycin dosage regimen.
  • Therapeutic drug monitoring showed adequate peak and trough serum concentrations.
  • Serum concentrations at day 4 were 27.3 μg/mL (peak) and 11.6 μg/mL (trough).
  • Serum concentrations at day 11 were 22.9 μg/mL (peak) and 7.9 μg/mL (trough).

Implications:

  • Higher daptomycin doses may be safe and effective for treating neonatal Gram-positive bacteremia.
  • This case supports further investigation into optimized daptomycin dosing for preterm neonates.
  • Findings may inform clinical guidelines for managing resistant Gram-positive infections in vulnerable infant populations.

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