DAPTOmycin (dap-to-mye-sin) Cubicin, Cubicin RF

 Indications

Complicated skin and skin structure infections caused

by aerobic Gram-positive bacteria. Staphylococcus aureus

bacteremia, including right-sided infective endocarditis

caused by methicillin-susceptible and methicillin-

resistant strains.

Action

Causes rapid depolarization of membrane potential following

binding to bacterial membrane; this results in

inhibition of protein, DNA, and RNA synthesis. Therapeutic

Effects: Death of bacteria with resolution of

infection. Spectrum: Active against Staphylococcus

aureus (including methicillin-resistant strains), Streptococcus

pyogenes, Streptococcus agalactiae, some S.

dysgalactiae, and Enterococcus faecalis (vancomycinsusceptible

strains).

Pharmacokinetics

Absorption: IV administration results in complete

bioavailability.

Distribution: Unknown.

Protein Binding: 92%.

Metabolism and Excretion: Metabolism not

known; mostly excreted by kidneys.

Half-life: 8.1 hr.

TIME/ACTION PROFILE

ROUTE ONSET PEAK DURATION

IV rapid end of infusion

24 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity.

Use Cautiously in: CCr 30 mL/min (doseprequired);

Moderate-to-severe renal impairment (may

havepclinical response); Geri: May havepclinical response

withqrisk of adverse reactions; OB: Use only if

clearly needed; Lactation: Lactation; Pedi: Children 1

yr (qrisk of muscular, neuromuscular, and CNS effects;

avoid use).

Adverse Reactions/Side Effects

CNS: dizziness. Resp: EOSINOPHILIC PNEUMONIA, dyspnea.

CV: hypertension, hypotension. GI: CLOSTRIDIUM

DIFFICILE-ASSOCIATED DIARRHEA (CDAD), constipation,

diarrhea, nausea, vomiting,qliver enzymes. GU: renal

failure. Derm: DRUG RASH WITH EOSINOPHILIA AND SYSTEMIC

SYMPTOMS (DRESS), pruritus, rash. Hemat: anemia.

Local: injection site reactions. MS:qCPK.

Misc: ANGIOEDEMA, fever.

Interactions

Drug-Drug: Tobramycinqblood levels. Concurrent

HMG-CoA reductase inhibitors mayqthe risk

of myopathy.

Route/Dosage

Complicated Skin/Skin Structure Infections

IV (Adults): 4 mg/kg every 24 hr for 7–14 days.

IV (Children 12–17 yr): 5 mg/kg every 24 hr for up

to 14 days.

IV (Children 7–11 yr): 7 mg/kg every 24 hr for up to

14 days.

IV (Children 2–6 yr): 9 mg/kg every 24 hr for up to

14 days.

IV (Children 1–2 yr): 10 mg/kg every 24 hr for up

to 14 days.

Renal Impairment

IV (Adults): CCr 30 mL/min—4 mg/kg every 48 hr

for 7–14 days; Hemodialysis and CAPD—4 mg/kg

every 48 hr for 2–6 wk with dose administered after

hemodialysis on hemodialysis days.

Staphylococcus aureus Bacteremia/

Right-Sided Infective Endocarditis)

IV (Adults): 6 mg/kg every 24 hr for 2–6 wk.

IV (Adults): CCr 30 mL/min—6 mg/kg every 48 hr

for 2–6 wk; Hemodialysis and CAPD—6 mg/kg every

48 hr for 2–6 wk with dose administered after hemodialysis

on hemodialysis days.

Renal Impairment

IV (Adults): CCr 30 mL/min—6 mg/kg every 48 hr

for 2–6 wk; Hemodialysis and CAPD—6 mg/kg every

48 hr for 2–6 wk with dose administered after hemodialysis

on hemodialysis days.

Availability (generic available)

Lyophylized powder for injection: 500 mg/vial.