CLINICAL VIGNETTE JPPT | Case Report
The Use of Daptomycin to Treat Methicillin-Resistant Staphylococcus Epidermidis Bacteremia in a Critically Ill Child with Renal Failure Stephen Morris, MPharm; Kate Gould, FRCPath; and Lee P. Ferguson, MBChB
Daptomycin is excreted primarily unchanged by the kidney. Dosage regimens in children with renal failure remain to be determined. We report the case of an 8-year-old child with multiorgan failure undergoing continuous peritoneal dialysis, successfully treated with intravenous daptomycin for methicillin-resistant Staphylococcus epidermidis bacteremia. A dosage of 8 mg/kg every 48 hour was used. Plasma peak and trough concentrations of daptomycin were 68 mg/L and 14.6 mg/L, respectively, on day 6 of treatment. The dosage regimen achieved daptomycin exposure comparable to that reported in adults undergoing continuous ambulatory peritoneal dialysis and receiving recommended dosages. ABBREVIATIONS AUC, area under the concentration-time curve; CPK, creatine phosphokinase; ECMO, extracorporeal membrane oxygenation; MIC, minimum inhibitory concentration KEYWORDS antibiotic; case report; continuous peritoneal dialysis; daptomycin; infection; pediatrics; renal
insufficiency
J Pediatr Pharmacol Ther 2017;22(4):300–303 DOI: 10.5863/1551-6776-22.4.300
Introduction Daptomycin is a novel cyclic lipopeptide antibiotic active against a range of Gram-positive pathogens.1 Clinical studies have shown daptomycin to be both safe and efficacious in adults with complicated skin and soft tissue infections and right-sided infective endocarditis due to Staphylococcus aureus infection.2,3 The dosage regimens recommended for pediatric patients with complicated skin and soft tissue infections are based on age (Table).4 In adults with renal impairment, adjustment of dose intervals to every 48 hours is recommended for patients with creatinine clearance of
The Use of Daptomycin to Treat Methicillin-Resistant Staphylococcus Epidermidis Bacteremia in a Critically Ill Child with Renal Failure Stephen Morris, MPharm; Kate Gould, FRCPath; and Lee P. Ferguson, MBChB
Daptomycin is excreted primarily unchanged by the kidney. Dosage regimens in children with renal failure remain to be determined. We report the case of an 8-year-old child with multiorgan failure undergoing continuous peritoneal dialysis, successfully treated with intravenous daptomycin for methicillin-resistant Staphylococcus epidermidis bacteremia. A dosage of 8 mg/kg every 48 hour was used. Plasma peak and trough concentrations of daptomycin were 68 mg/L and 14.6 mg/L, respectively, on day 6 of treatment. The dosage regimen achieved daptomycin exposure comparable to that reported in adults undergoing continuous ambulatory peritoneal dialysis and receiving recommended dosages. ABBREVIATIONS AUC, area under the concentration-time curve; CPK, creatine phosphokinase; ECMO, extracorporeal membrane oxygenation; MIC, minimum inhibitory concentration KEYWORDS antibiotic; case report; continuous peritoneal dialysis; daptomycin; infection; pediatrics; renal
insufficiency
J Pediatr Pharmacol Ther 2017;22(4):300–303 DOI: 10.5863/1551-6776-22.4.300
Introduction Daptomycin is a novel cyclic lipopeptide antibiotic active against a range of Gram-positive pathogens.1 Clinical studies have shown daptomycin to be both safe and efficacious in adults with complicated skin and soft tissue infections and right-sided infective endocarditis due to Staphylococcus aureus infection.2,3 The dosage regimens recommended for pediatric patients with complicated skin and soft tissue infections are based on age (Table).4 In adults with renal impairment, adjustment of dose intervals to every 48 hours is recommended for patients with creatinine clearance of
