Cyclic lipopeptide antibiotic
Daptomycin
Brand names: Cubicin
Adult dose
Dose: 4mg/kg IV OD (skin/soft tissue); 6mg/kg OD (bacteraemia/RIE); 8–10mg/kg in selected cases
Route: IV
Frequency: OD
Clinical pearls
- BSAC: gram-positive cover including MRSA, VRE — useful in S. aureus bacteraemia, right-sided IE
- NOT effective in pneumonia (inactivated by surfactant)
- UKHSA AMR stewardship — restricted
- Stop statins where possible during therapy
Contraindications
- Hypersensitivity
Side effects
- Myopathy / rhabdomyolysis
- Eosinophilic pneumonia
- Peripheral neuropathy
- C. difficile
- Eosinophilia
- Hepatotoxicity
Interactions
- Statins (hold if possible — additive myopathy)
- Tobramycin
- Warfarin (INR fluctuation)
Monitoring
- CK weekly
- LFTs
- Renal function
- Pulmonary symptoms (eosinophilic pneumonia)
Reference: BNF; BSAC; UKHSA AMR; ESCMID; SmPC; https://bnf.nice.org.uk/drugs/daptomycin/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Centor / McIsaac Score for Strep Pharyngitis · Throat
- Rome IV Diagnostic Criteria for Cyclic Vomiting Syndrome (CVS) · Functional GI Disorders
- FeverPAIN Score for Strep Throat · Throat
- Jarisch-Herxheimer Reaction Severity Assessment · Treatment Reactions
- PID Severity (CDC Diagnostic Criteria) · Gynaecological Infections
- Gustilo-Anderson Classification (Open Fractures) · Fracture Classification
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023