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00925njm 22002777a 4500 dc Galar, Alicia author Sánchez-Somolinos, Mar author Juárez, Miriam author Verde, Eduardo author Burillo Albizua, Almudena author Bouza Santiago, Emilio author Valerio Minero, Maricela author Muñoz García, Patricia Carmen author Cercenado Mansilla, Emilia author García González, Xandra author 2019-01-14 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. 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. 0924-8579 10.1016/j.ijantimicag.2018.09.015 https://hdl.handle.net/20.500.14352/116945 https://doi.org/10.1016/j.ijantimicag.2018.09.015 https://www.sciencedirect.com/science/article/pii/S0924857918302747?via%3Dihub Current use of daptomycin and systematic therapeutic drug monitoring: Clinical experience in a tertiary care institution