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High-dose, short-interval daptomycin regimen was safe and well tolerated in three patients with chronic renal failure

Kaori Yabuno1, Masafumi Seki, Koji Miyawaki

  • 1Division of Infection Control and Prevention, Osaka University Hospital, Osaka, Japan ; Department of Pharmacy, Osaka University Hospital, Osaka, Japan.

Clinical Pharmacology : Advances and Applications
|November 16, 2013
PubMed
Abstract

Insights

High-dose daily daptomycin effectively treated severe methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant S. epidermidis (MRSE) infections in patients with chronic renal failure. This approach proved safe, with no significant adverse effects observed.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Pharmacology

Background:

  • Daptomycin is recommended at 4-6 mg/kg/day for specific MRSA infections.
  • Alternate-day dosing is typical for patients with renal impairment.
  • Higher daily doses are being explored as an alternative treatment.

Purpose of the Study:

  • To evaluate the safety and efficacy of high-dose, daily daptomycin in patients with chronic renal failure and severe MRSA/MRSE infections.
  • To assess if higher daptomycin doses can be safely administered daily despite renal dysfunction.

Main Methods:

  • Case report of three patients with chronic renal failure and severe MRSA/MRSE infections.
  • Patients received daily high-dose daptomycin therapy.
  • Treatment outcomes and adverse effects were monitored.

Main Results:

  • All three patients achieved successful treatment outcomes.
  • Previous antibiotic treatments (vancomycin, teicoplanin, linezolid) had failed.
  • No significant adverse effects, including elevated creatinine or creatine phosphokinase, were observed despite daily administration.

Conclusions:

  • High-dose, daily daptomycin is a potentially safe and effective treatment option for severe MRSA/MRSE infections in patients with renal dysfunction.
  • This regimen should be considered for patients with chronic renal failure and severe infections where other treatments have failed.
Keywords:
creatine phosphokinasedaptomycinhigh-dosemethicillin-resistant Staphylococcus aureusrenal failure

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