Daptomycin Pharmacology

Daptomycin, a cyclic lipopeptide antibiotic marketed as Cubicin, functions through calcium-dependent depolarization of gram-positive bacterial cell membranes, effectively targeting resistant organisms like MRSA and VRE. While essential for treating skin, soft tissue, and bloodstream infections, it is strictly contraindicated for pneumonia because pulmonary surfactant inactivates the drug. Clinical administration requires weight-based IV dosing, with necessary adjustments for patients with renal impairment. Practitioners must monitor for myopathy and rhabdomyolysis, particularly when co-administering statins, as both contribute to additive muscle toxicity. Routine CPK and renal function testing are vital for safety, especially during extended courses of therapy. Because the drug does not cross the blood-brain barrier effectively, it remains unsuitable for central nervous system infections.