Related Experiment Video
Updated: Jan 12, 2026
08:09
A Doxorubicin-induced Cardiomyopathy Model in Adult Zebrafish
Published on: June 7, 2018
10.3K
Risk factors of daptomycin overexposure: a case-control study
Clotilde Vellat1,2, Romain Garreau1,2,3, Aurélien Millet4
1Laboratoire de Biométrie et Biologie Evolutive, UMR 5558, CNRS & Université Lyon 1, Villeurbanne, France.
Antimicrobial Agents and Chemotherapy
|November 7, 2025
Summary
High body mass index (BMI) and irbesartan use increase daptomycin overexposure risk. Renal function impacts daptomycin levels; avoid weight-based dosing in obese patients.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Drug Safety
Background:
- Therapeutic drug monitoring (TDM) of daptomycin is crucial for optimizing patient outcomes.
- Unexplained high trough concentrations of daptomycin have been observed, necessitating identification of contributing factors.
Purpose of the Study:
- To identify risk factors associated with daptomycin overexposure in patients undergoing routine therapeutic drug monitoring.
- To investigate the influence of patient characteristics and co-administered medications on daptomycin trough concentrations.
Main Methods:
- A case-control study design was employed, comparing patients with daptomycin trough concentrations (Cmin) ≥60 mg/L (cases) to those with Cmin <60 mg/L (controls).
- Logistic regression models were used for univariate and multivariate analyses to identify risk factors.
- Subgroup analyses and pharmacokinetic parameter comparisons were conducted.
Main Results:
- Increasing body mass index (BMI) (OR 2.9) and co-administration of irbesartan (OR 6.1) were significant risk factors for daptomycin overexposure.
- Increasing creatinine clearance was associated with a decreased risk of overexposure (OR 0.16).
- The influence of BMI was linked to non-linear pharmacokinetics and weight-based dosing in obese individuals.
Conclusions:
- Elevated BMI and concurrent irbesartan use are associated with an increased risk of daptomycin overexposure, beyond renal impairment.
- Weight-based dosing of daptomycin should be reconsidered in obese patients to prevent overexposure.
Related Concept Videos
01:15Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations
226
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...
226
01:26Factors Affecting the Risk of Infection
13.2K
The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
13.2K
01:29Therapeutic Drug Monitoring: Affecting Factors
189
Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
189
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
254
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...
254
01:18Effects of EDTA on End-Point Detection Methods
607
Different methods, such as visual observance of metal-ion indicators, spectroscopic techniques, and potentiometric methods, can determine the endpoint of an EDTA titration.
In the visual method, metal-ion indicators (metallochromic dyes), which have distinct colors in their free and complex forms, are added to the mixture to signal the titration's end point. They form stable complexes with metal ions, but these complexes are weaker than the corresponding metal–EDTA complexes. As a...
In the visual method, metal-ion indicators (metallochromic dyes), which have distinct colors in their free and complex forms, are added to the mixture to signal the titration's end point. They form stable complexes with metal ions, but these complexes are weaker than the corresponding metal–EDTA complexes. As a...
607