Safety of Daptomycin in Patients Receiving Hemodialysis

Mueller, Bruce A.; Crompton, Jason A.; Donovan, Brian; Yankalev, Sara; Lamp, Kenneth C.

doi:10.1592/phco.31.7.665

Cited by 13 publications

(7 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The dose should be increased by 50% during the 72-hour postdialysis interval even if the dose was given intradialytically (eg, increase from 6 to 9 mg/kg). 36,[42][43][44][45] The dose should increase an additional 15% to 20% if dosed intradialytically for the 48-hour postdialysis intervals (eg, increase from 420 to 500 mg for a 70-kg patient targeting a 6-mg/kg dose). 36,[42][43][44][45] Vancomycin loading doses of 15 to 25 mg/kg (actual dry body weight) are suggested to establish sufficient levels above the MIC to maximize exposure.…”

Section: Intermittent Hemodialysismentioning

confidence: 99%

“…36,[42][43][44][45] The dose should increase an additional 15% to 20% if dosed intradialytically for the 48-hour postdialysis intervals (eg, increase from 420 to 500 mg for a 70-kg patient targeting a 6-mg/kg dose). 36,[42][43][44][45] Vancomycin loading doses of 15 to 25 mg/kg (actual dry body weight) are suggested to establish sufficient levels above the MIC to maximize exposure. 46,47 One previously published algorithm 48 utilizes a postdialysis dosing approach guided by predialysis vancomycin serum concentrations.…”

Section: Intermittent Hemodialysismentioning

confidence: 99%

See 1 more Smart Citation

Antibiotic Dosing for Critically Ill Adult Patients Receiving Intermittent Hemodialysis, Prolonged Intermittent Renal Replacement Therapy, and Continuous Renal Replacement Therapy: An Update

et al. 2019

View full text Add to dashboard Cite

Objective: To summarize current antibiotic dosing recommendations in critically ill patients receiving intermittent hemodialysis (IHD), prolonged intermittent renal replacement therapy (PIRRT), and continuous renal replacement therapy (CRRT), including considerations for individualizing therapy. Data Sources: A literature search of PubMed from January 2008 to May 2019 was performed to identify English-language literature in which dosing recommendations were proposed for antibiotics commonly used in critically ill patients receiving IHD, PIRRT, or CRRT. Study Selection and Data Extraction: All pertinent reviews, selected studies, and references were evaluated to ensure appropriateness for inclusion. Data Synthesis: Updated empirical dosing considerations are proposed for antibiotics in critically ill patients receiving IHD, PIRRT, and CRRT with recommendations for individualizing therapy. Relevance to Patient Care and Clinical Practice: This review defines principles for assessing renal function, identifies RRT system properties affecting drug clearance and drug properties affecting clearance during RRT, outlines pharmacokinetic and pharmacodynamic dosing considerations, reviews pertinent updates in the literature, develops updated empirical dosing recommendations, and highlights important factors for individualizing therapy in critically ill patients. Conclusions: Appropriate antimicrobial selection and dosing are vital to improve clinical outcomes. Dosing recommendations should be applied cautiously with efforts to consider local epidemiology and resistance patterns, antibiotic dosing and infusion strategies, renal replacement modalities, patient-specific considerations, severity of illness, residual renal function, comorbidities, and patient response to therapy. Recommendations provided herein are intended to serve as a guide in developing and revising therapy plans individualized to meet a patient’s needs.

show abstract

Section: Intermittent Hemodialysismentioning

confidence: 99%

Section: Intermittent Hemodialysismentioning

confidence: 99%

Antibiotic Dosing for Critically Ill Adult Patients Receiving Intermittent Hemodialysis, Prolonged Intermittent Renal Replacement Therapy, and Continuous Renal Replacement Therapy: An Update

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The recommended dosing regimen of daptomycin for the patients with CL Cr <30 mL/min or under renal replacement therapy is 4–6 mg/kg every 48 h based on approved indications. 11 However, there may be a discrepancy between the approved dosing regimen and the hemodialysis schedule. Daptomycin can be removed by hemodialysis, and dosing regimen to give the doses three times a week coinciding with each dialysis session was proposed.…”

Section: Discussionmentioning

confidence: 99%

“…The result was not statistically significant ( P =0.52), but it was consistent with the finding of a previous study reporting more frequent dosing led to increased muscle toxicity. 11 Use of high-dose daptomycin in patients with renal impairment is still a concern, and the dosing frequency should be included for clinical consideration. 7 …”

Section: Discussionmentioning

confidence: 99%

Safety of high-dose daptomycin in patients with severe renal impairment

Tai¹,

Shao²,

Chen³

et al. 2018

TCRM

View full text Add to dashboard Cite

BackgroundTreatment options are limited for infections due to multidrug-resistant Gram-positive pathogens. Daptomycin is a lipopeptide antibiotic with concentration-dependent killing characteristic and dose-dependent post-antibiotic effect. To achieve optimized pharma-codynamic effect, some experts advocated using a high dose of daptomycin (≥9 mg/kg) for severe infections. However, the safety of high-dose therapy in patients with renal impairment remains unknown. This study was aimed to evaluate the safety of daptomycin in patients with severe renal impairment.MethodsThis was a retrospective study performed by reviewing electronic medical records. Patients with severe renal impairment who were treated with daptomycin in a tertiary teaching hospital between January 1, 2013, and June 30, 2016, were included for evaluation. The incidence rates of creatine kinase (CK) elevation between high-dose (≥9 mg/kg) and standard-dose (<9 mg/kg) groups were compared.ResultsOverall, 164 patients met the inclusion criteria, and 114 (69.5%) of them were on renal replacement therapy. Vancomycin-resistant enterococci were the most common pathogens (61.3%) of the patients with documented pathogens. The treatment success rate was 51.6% in the 91 patients with bacteremia. The average dose of daptomycin was 8.0±2.3 mg/kg, and 37 (22.6%) patients received ≥9 mg/kg. CK levels were followed in 108 (65.9%) patients. Significantly higher incidence of CK elevation was found in the high-dose group compared with that in the standard-dose group (10.8% vs 1.6%, P<0.05). Moreover, patients with elevated CK received a higher dose of daptomycin than those without (9.3±1.2 vs 7.9±2.3 mg/kg, P<0.05). There was no significant difference in the rate of CK elevation between patients treated with different dosing frequency or with the concurrent use of statins, fibrate, or colchicine.ConclusionsIn patients with severe renal impairment, high-dose (≥9 mg/kg) daptomycin therapy may result in a significantly higher incidence of CK elevation. More frequent CK monitoring is warranted to avoid potential harm in this population.

show abstract

“…In a review of the Cubicin Outcomes Registry and Experience (CORE) data from 2005-2008, 393 patients receiving IHD were administered daptomycin at an average dose of 6 mg/kg (range = 2-14.75 mg/kg) for 12 days (range = 1-84 days). 24 The majority of patients received daptomycin doses every 48 hours (64%), with 22% of subjects receiving daptomycin three times a week following IHD and 8% receiving doses every 24 hours. The registry reported 200 adverse events in 94 IHD subjects; 7% of the total adverse drug events (ADEs) were classified as possibly related to daptomycin.…”

Section: Literature Reviewmentioning

confidence: 99%

Daptomycin Dosing Strategies in Patients Receiving Thrice-Weekly Intermittent Hemodialysis

2013

View full text Add to dashboard Cite

show abstract

Safety of Daptomycin in Patients Receiving Hemodialysis

Abstract: In these patients undergoing hemodialysis, daptomycin was a well-tolerated treatment for gram-positive infections across several doses and dosing frequencies. Further study in prospective trials is warranted.

Cited by 13 publications

References 22 publications

Antibiotic Dosing for Critically Ill Adult Patients Receiving Intermittent Hemodialysis, Prolonged Intermittent Renal Replacement Therapy, and Continuous Renal Replacement Therapy: An Update

Antibiotic Dosing for Critically Ill Adult Patients Receiving Intermittent Hemodialysis, Prolonged Intermittent Renal Replacement Therapy, and Continuous Renal Replacement Therapy: An Update

Safety of high-dose daptomycin in patients with severe renal impairment

Daptomycin Dosing Strategies in Patients Receiving Thrice-Weekly Intermittent Hemodialysis

Contact Info

Product

Resources

About