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Related Concept Videos

Estimation of k and VD of Aminoglycosides01:20

Estimation of k and VD of Aminoglycosides

Aminoglycosides are a class of antibiotics used to treat various bacterial infections. Clinicians must determine the elimination rate constant (k) and volume of distribution (VD) to optimize therapeutic efficacy and minimize toxicity. The k value represents the rate at which the drug is removed from the body, and the VD reflects the degree to which the drug distributes into body tissues. Accurately estimating these parameters allows healthcare professionals to tailor drug dosing to individual...
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Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

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Clinical Significance of Antibiotic Resistance01:25

Clinical Significance of Antibiotic Resistance

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Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
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Acute Pyelonephritis II: Diagnostic Studies and Management

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Related Experiment Video

Updated: May 31, 2026

A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically
11:28

A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically

Published on: September 9, 2015

Vancomycin-resistant enterococcal bacteraemia and daptomycin: are higher doses necessary?

Esther A King1, Dorothy McCoy, Samit Desai

  • 1Department of Pharmacy, Hackensack University Medical Center, Hackensack, NJ, USA. esther.aizenberg@gmail.com

The Journal of Antimicrobial Chemotherapy
|June 24, 2011
PubMed
Summary

This study found no difference in microbiological cure time for vancomycin-resistant enterococci (VRE) treated with standard or high-dose daptomycin, regardless of minimum inhibitory concentration (MIC). Prior vancomycin exposure did not affect daptomycin MICs.

Related Experiment Videos

Last Updated: May 31, 2026

A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically
11:28

A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically

Published on: September 9, 2015

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Clinical Microbiology

Background:

  • Vancomycin-resistant enterococci (VRE) infections pose a significant challenge, with daptomycin susceptibility defined by a minimum inhibitory concentration (MIC) of ≤ 4 mg/L.
  • Daptomycin's concentration-dependent killing necessitates adequate drug exposure, raising concerns for VRE isolates with MICs nearing the susceptible threshold (3-4 mg/L).
  • Higher daptomycin doses may be considered for VRE with elevated MICs.

Purpose of the Study:

  • To compare time to microbiological cure (TMC) in adult VRE bacteremia patients receiving standard (≤ 6 mg/kg) versus high (> 6 mg/kg) daptomycin doses.
  • To determine if TMC varied based on daptomycin MIC values.
  • To evaluate daptomycin MIC distribution and the association between prior vancomycin exposure and higher daptomycin MICs.

Main Methods:

  • A single-center retrospective chart review of adult VRE bacteremia cases treated with daptomycin as initial therapy.
  • Primary outcome: TMC comparison between standard and high daptomycin dose groups, stratified by MIC.
  • Secondary outcomes: Daptomycin MIC distribution analysis and assessment of prior vancomycin exposure's impact on MICs.

Main Results:

  • Forty-six patients were included in the primary analysis; 60.9% were neutropenic.
  • Median TMC was 2 days for both standard and high daptomycin dose groups, with no significant difference between MIC subgroups (≤ 2 mg/L vs. >2 and ≤ 4 mg/L).
  • In the secondary analysis of 227 VRE isolates, 62% had daptomycin MICs of 3-4 mg/L, with similar prior vancomycin exposure across MIC groups.

Conclusions:

  • This retrospective review did not demonstrate a difference in TMC based on daptomycin dose or MIC for VRE bacteremia.
  • The study was not powered to detect differences in TMC, and limitations exist.
  • Prior vancomycin exposure did not appear to influence daptomycin MICs, and the observed frequency of higher MICs (3-4 mg/L) exceeds previously reported literature values.