RT Journal Article
T1 Current use of daptomycin and systematic therapeutic drug monitoring: Clinical experience in a tertiary care institution
A1 Galar, Alicia
A1 Sánchez-Somolinos, Mar
A1 Juárez, Miriam
A1 Verde, Eduardo
A1 Burillo Albizua, Almudena
A1 Bouza Santiago, Emilio
A1 Valerio Minero, Maricela
A1 Muñoz García, Patricia Carmen
A1 Cercenado Mansilla, Emilia
A1 García González, Xandra
AB Therapeutic drug monitoring (TDM) could optimise daptomycin use. However, no validated serum target levels have been established. This prospective study at a tertiary centre including hospitalised patients receiving daptomycin aimed to evaluate the adequacy of daptomycin doses in a real-life study, assess interpatient variability in serum levels, identify predictive factors for non-adequate serum levels and assess their clinical impact. Blood samples [trough ( C min ) and peak ( C max ) levels] were drawn ≥3 days post-treatment initiation. Serum daptomycin concentrations were determined by HPLC. Outcome was classified as: (i) favourable, if clinical improvement or cure occurred with no adverse events; or (ii) poor, in the case of no clinical response, recurrence, related mortality or if adverse events were detected. Sixty-three patients (63.5% male; median age 63.0 years) were included. The most common indications for daptomycin use were bacteraemia (46.0%), complicated skin and soft-tissue infection (30.2%) and endovascular infection (15.9%). The initial dosage was adequate in 43 patients (68.3%), low in 14 (22.2%) and high in 6 (9.5%). Large interindividual variability in serum levels was observed, with a median C min of 10.6 mg/L (range 1.3–44.7 mg/L) and median C max of 44.0 mg/L (range 3.0–93.7 mg/L). Multivariate analysis showed that C min < 3.18 mg/L was independently related to poor outcome (OR = 6.465, 95% CI 1.032–40.087; P = 0.046). High variability in daptomycin use and serum levels was detected. Specific serum targets were identified as risk factors for poor outcome. TDM might be useful to optimise daptomycin doses and to avoid therapeutic failure.
PB Elsevier
SN 0924-8579
YR 2019
FD 2019-01-14
LK https://hdl.handle.net/20.500.14352/116945
UL https://hdl.handle.net/20.500.14352/116945
LA eng
NO Galar A, Muñoz P, Valerio M, Cercenado E, García-González X, Burillo A, Sánchez-Somolinos M, Juárez M, Verde E, Bouza E. Current use of daptomycin and systematic therapeutic drug monitoring: Clinical experience in a tertiary care institution. Int J Antimicrob Agents. 2019 Jan;53(1):40-48. doi: 10.1016/j.ijantimicag.2018.09.015. Epub 2018 Sep 19. PMID: 30243587.
DS Docta Complutense
RD 12 abr 2025