Related Experiment Video

Updated: Jan 6, 2026

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
09:02

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

Published on: February 2, 2021

4.8K

Retrospective study on clinical efficacy and safety for daptomycin intermittent doses with or without loading dose in

Hideo Kato1, Mao Hagihara2, Yuichi Shibata3

  • 1Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Clinical Infectious Diseases, Aichi Medical University, Japan.

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
|October 3, 2019
PubMed

Insights

Daptomycin intermittent doses are linked to higher mortality rates in patients, especially those with bacteremia. A daptomycin loading dose, however, improved outcomes and reduced mortality in renal failure patients without increasing adverse effects.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Pharmacology

Background:

  • Daptomycin (DAP) is an antibiotic used for serious Gram-positive bacterial infections.
  • Optimal dosing strategies, particularly in patients with renal impairment, are crucial for efficacy and safety.
  • Previous studies have not fully elucidated the impact of intermittent dosing versus daily dosing or the benefit of loading doses in specific patient populations.

Purpose of the Study:

  • To evaluate the efficacy and safety of intermittent daptomycin doses compared to daily doses.
  • To assess the effectiveness of a daptomycin loading dose in patients with renal failure receiving intermittent daptomycin therapy.

Main Methods:

  • A retrospective study analyzing 197 patients who received daptomycin for at least 3 days between 2014 and 2017.
  • Comparison of clinical outcomes, microbiological outcomes, and safety profiles between different daptomycin dosing regimens (daily, every 48 hours, thrice per week).
  • Analysis of the impact of a daptomycin loading dose on mortality and inflammation markers in renal failure patients.

Main Results:

  • Intermittent daptomycin dosing (every 48 hours or thrice per week) was associated with significantly higher mortality rates compared to daily dosing (28.3% and 30.0% vs. 6.5%, p=0.0320).
  • Bacteremia patients receiving intermittent daptomycin showed significantly higher mortality than those on daily doses (p=0.0160).
  • A daptomycin loading dose decreased mortality and accelerated inflammation improvement in renal failure patients, particularly those on thrice-weekly dosing, without significantly increasing adverse effects.

Conclusions:

  • Intermittent daptomycin dosing is associated with poorer clinical outcomes compared to daily dosing.
  • A daptomycin loading dose represents a potentially better clinical option for patients receiving intermittent daptomycin, especially in renal failure.
  • Further research into optimized daptomycin dosing strategies is warranted to improve patient outcomes.
Keywords:
DaptomycinDialysis patientIntermittent doseLoading doseRenal failure patient

More Related Videos

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats06:38

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats

Published on: March 11, 2016

12.5K
Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin07:38

Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin

Published on: May 6, 2018

8.8K

Related Concept Videos

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

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...
209
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
181
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
396
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
238
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
204
Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance01:25

Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance

In healthy individuals, serum creatinine levels remain stable due to a balance between its constant production—primarily from muscle metabolism—and renal excretion. Creatinine is freely filtered by the glomeruli, making it a valuable marker for estimating renal function. When the glomerular filtration rate (GFR) decreases, the kidneys can only eliminate less creatinine, causing serum levels to rise.Serum creatinine concentration is widely used to estimate creatinine clearance...
161