Pharmacokinetics of daptomycin in a critically ill adolescent with vancomycin-resistant enterococcal endocarditis

• Published in: Pharmacotherapy Vol. 26; no. 5; p. 694
• Main Authors: Akins, Ronda L, Haase, Mark R, Levy, Eric N
• Format: Journal Article
• Language: English
• Published: United States 01.05.2006
• Subjects: Adolescent; Anemia, Aplastic - therapy; Anti-Bacterial Agents - pharmacokinetics; Anti-Bacterial Agents - therapeutic use; Bone Marrow Transplantation - adverse effects; Critical Illness; Daptomycin - pharmacokinetics; Daptomycin - therapeutic use; Endocarditis, Bacterial - drug therapy; Endocarditis, Bacterial - metabolism; Enterococcus faecium; Fatal Outcome; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - metabolism; Humans; Male; Vancomycin Resistance
• ISSN: 0277-0008
• DOI: 10.1592/phco.26.5.694

Daptomycin is a lipopeptide antibiotic active against multidrug-resistant gram-positive organisms. Our search of the literature found no published pediatric pharmacokinetic data. We report the use of pharmacokinetic analysis of daptomycin in a 13-year-old boy with vancomycin-resistant Enterococcus faecium endocarditis. Pharamcokinetic parameters were found to be significantly different from published adult parameters, such as a faster elimination rate, shorter half-life, and increased clearance. These age-related differences in the pharmacokinetic profile of daptomycin have significant dosing implications. As the use of this drug for off-label indications and in pediatric populations increases, it is important for clinicians to better understand the drug's pharmacokinetic profile in these patient populations.