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Daptomycin obesity

Ryan K Dare, Chad Tewell, Bryan Harris, Patty W Wright, Sara L Van Driest, Eric Farber-Eger, George E Nelson, Thomas R Talbot
Background: Daptomycin-associated myopathy has been identified in 2-14% of patients, and rhabdomyolysis is a known adverse effect. Although risk factors for daptomycin-associated myopathy are poorly defined, creatine phosphokinase (CPK) monitoring and temporary discontinuation of HMG-CoA reductase inhibitors, or "statins", has been recommended. Methods: We conducted a single-center, retrospective, matched case-control risk factor analysis in adult and pediatric patients from 2004-2015...
April 16, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Susan E Smith, Kelli A Rumbaugh
PURPOSE: Persistent elevation of prothrombin time (PT) and International Normalized Ratio (INR) values in a patient receiving daptomycin is reported. SUMMARY: A morbidly obese 51-year-old man was hospitalized for evaluation for surgical intervention for gallstone pancreatitis and biliary obstruction. Previously prescribed warfarin therapy was withheld due to suspected coagulopathy and an elevated INR (5.1), and warfarin reversal was initiated. After undergoing partial cholecystectomy on hospital day 6, the patient developed sepsis and was treated with i...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
Mordechai Grupper, David P Nicolau
PURPOSE OF REVIEW: Skin and soft tissue infections (SSTIs) are prevalent in the obese population, with rising trend expected. Although numerous antibiotics are available for the prevention and treatment of SSTIs, their characterization in obese patients is not a regulatory mandate. Consequently, information that carries importance for optimizing the dosing regimen in the obese population may not be readily available. This review focuses on the most recent pharmacokinetic and pharmacodynamic data on this topic with attention to cefazolin for surgical prophylaxis as well as antibiotics that are active against methicillin-resistant Staphylococcus aureus (MRSA)...
April 2017: Current Opinion in Infectious Diseases
Stephanie Natale, John Bradley, William Huy Nguyen, Tri Tran, Pamela Ny, Kirsten La, Eva Vivian, Jennifer Le
Limited data exist for appropriate drug dosing in obese children. This comprehensive review summarizes pharmacokinetic (PK) alterations that occur with age and obesity, and these effects on antimicrobial dosing. A thorough comparison of different measures of body weight and specific antimicrobial agents including cefazolin, cefepime, ceftazidime, daptomycin, doripenem, gentamicin, linezolid, meropenem, piperacillin-tazobactam, tobramycin, vancomycin, and voriconazole is presented. PubMed (1966-July 2015) and Cochrane Library searches were performed using these key terms: children, pharmacokinetic, obesity, overweight, body mass index, ideal body weight, lean body weight, body composition, and specific antimicrobial drugs...
March 2017: Pharmacotherapy
Celestine Ishiekwene, Monica Ghitan, Margaret Kuhn-Basti, Edward Chapnick, Yu Shia Lin
Staphylococcus lugdunensis (S. lugdunensis) is a coagulase negative staphylococcus (CoNS) that can cause destructive infective endocarditis. S. lugdunensis, unlike other CoNS, should be considered to be a pathogen. We report the first case of S. lugdunensis endocarditis causing ventricular septal defect and destruction of the aortic and mitral valves. A 53-year-old male with morbid obesity and COPD presented with intermittent fever and progressive shortness of breath for 2 weeks. Chest examination showed bilateral basal crepitations, and a grade 2 systolic murmur along the right sternal border...
2017: IDCases
Sara Elizabeth Boyd, Esmita Charani, Tracy Lyons, Gary Frost, Alison Helen Holmes
BACKGROUND: Obesity is on course to overtake being underweight as a global disease burden. Obesity alters antibacterial pharmacokinetics (PK) and pharmacodynamics (PD). Historically, drug PK/PD parameters have not been studied in obese populations. This means dose recommendations risk being sub-therapeutic in a population at increased risk of infection. Suboptimal antibacterial prescribing is widely associated with treatment failure, worse clinical outcomes, unnecessary escalation to broad-spectrum therapy and the emergence of antimicrobial resistance (AMR)...
December 2016: Journal of Antimicrobial Chemotherapy
John J Veillette, Puja Van Epps
OBJECTIVE: To report a case of ertapenem-induced hallucinations and delirium in an elderly, morbidly obese patient. SETTING/PRACTICE DESCRIPTION: A 71-year-old male was receiving intravenous antibiotics at an outside nursing facility through our Outpatient Parenteral Antimicrobial Therapy (OPAT) program, which has enrolled more than 800 patients since 2009. He was admitted to our medical center, a 673-bed tertiary health care facility, which provides care to more than 100,000 veterans in Northeast Ohio...
April 2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Abdulaziz S Alobaid, Maya Hites, Jeffrey Lipman, Fabio Silvio Taccone, Jason A Roberts
The increased prevalence of obesity presents challenges for clinicians aiming to provide optimised antimicrobial dosing in the intensive care unit. Obesity is likely to exacerbate the alterations to antimicrobial pharmacokinetics when the chronic diseases associated with obesity exist with the acute pathophysiological changes associated with critical illness. The purpose of this paper is to review the potential pharmacokinetic (PK) changes of antimicrobials in obese critically ill patients and the implications for appropriate dosing...
April 2016: International Journal of Antimicrobial Agents
Eliane Gandolpho Tótoli, Sanjay Garg, Hérida Regina Nunes Salgado
Daptomycin is the first approved member of a new class of antimicrobials, the cyclic lipopeptides, and presents selective action against gram-positive bacteria, including methicillin- and vancomycin-resistant strains. Considering that resistance to daptomycin is rare, the drug has become very important for current clinical practice. This review covers daptomycin's physicochemical characteristics, antibacterial spectrum, mechanism of action, pharmacokinetics, clinical applications, side effects, drug interactions, and the analytical methods used to measure daptomycin in pharmaceutical products and biologic samples...
December 2015: Therapeutic Drug Monitoring
Ozgür Atmaca, Pınar Zarakolu, Ceren Karahan, Banu Cakır, Serhat Unal
The aim of this study was to evaluate methicillin-resistant Staphylococcus aureus (MRSA) bacteremia cases who were followed at the Infectious Diseases Unit of Internal Medicine Department, at Hacettepe University Adult and Oncology Hospitals between January 2004-December 2011. A total of 198 patients, of them 99 had positive MRSA blood cultures (case group), and 99 without MRSA bacteremia (control group) who were selected randomly among patients at the same wards during the same time period, were included in the study...
October 2014: Mikrobiyoloji Bülteni
Fernanda S Cavalcante, Dennis de C Ferreira, Raiane C Chamon, Thaina M da Costa, Fernanda Maia, Elaine M Barros, Tatiana Silva Dantas, Kátia R N Dos Santos
BACKGROUND: Daptomycin is an alternative option for the treatment of catheter-related bloodstream-infections caused by methicillin-resistant Staphylococcus aureus. This study reports a case of a daptomycin and methicillin-resistant Staphylococcus aureus isolate recovered from the blood of a Brazilian patient undergoing hemodialysis. CASE PRESENTATION: A 64-year-old white male patient suffering from diabetes mellitus, systolic hypertension, heart disease with a coronary stent, obesity and chronic renal failure and on use of permcath catheter developed a catheter-related bloodstream-infection by a daptomycin-methicillin-resistant Staphylococcus aureus isolate after one month of daptomycin therapy...
2014: BMC Research Notes
A K Polso, J L Lassiter, J L Nagel
WHAT IS KNOWN AND OBJECTIVE: Obesity is a significant burden on the healthcare system in the United States, and determining the appropriate antimicrobial dosing regimen in morbidly obese patients is challenging. Morbidly obese patients have documented differences in pharmacokinetic and pharmacodynamic properties compared to normal-weight patients, which impact antibiotic efficacy and toxicity. The Food and Drug Administration does not recognize obesity as a special population and does not require pharmaceutical companies to perform studies specific to obese patients...
December 2014: Journal of Clinical Pharmacy and Therapeutics
Kenna D Payne, Ronald G Hall
Obesity is a global pandemic affecting 33% of adults in the United States. Obese persons receiving cefazolin or fluconazole have been shown to have worse outcomes with suboptimal dosing. Studies evaluating the safety of colistin, daptomycin, and vancomycin have shown increased weight or obesity may potentially increase toxicity. Many antimicrobials lack pharmacokinetic data to support dose individuation in obese persons, due in part to the lack of obese patients in drug development studies. A one size fits all approach to dose optimization for obese patients is not likely...
July 2014: Expert Review of Anti-infective Therapy
Olga M Klibanov, Stephen Vickery, Cynthia Nortey
OBJECTIVE: To report a case of infective panniculitis in a morbidly obese, pregnant woman, which was successfully treated with daptomycin. CASE SUMMARY: A 34-year-old, 27-week pregnant, morbidly obese woman with a history of skin/soft-tissue infections and diabetes mellitus, presented with panniculitis. Initial treatment with β-lactam antibiotics did not result in clinical improvement. Methicillin-resistant Staphylococcus aureus was suspected, and 14 days of daptomycin 4 mg/kg (using total body weight) resulted in a clinical cure, without any adverse effects on the mother or the neonate...
May 2014: Annals of Pharmacotherapy
M Bassetti, M Baguneid, E Bouza, M Dryden, D Nathwani, M Wilcox
Complicated skin and soft tissue infections (cSSTIs) are a diverse group of infections, with a range of presentations and microbiological causes. Hospitalization is common for patients with a cSSTI, which is treated by drainage of the affected area and with antibiotics. Host factors such as co-morbidities, and microbial factors, in particular drug resistance, complicate the management of these infections. Methicillin-resistant Staphylococcus aureus (MRSA) is an important cSSTI pathogen in Europe, and its involvement can be associated with poor patient outcomes...
April 2014: Clinical Microbiology and Infection
J M Gutiérrez Urbón, P Linares Mondéjar, I Martin Herranz
Daptomycin is a cyclic lipopeptide antibiotic whose approved dose is 4 to 6 mg/kg/day. Today it is a matter of controversy the use of higher doses of daptomycin in a range of 8-12 mg/kg/ day, for the treatment of Staphylococcus aureus infections, justified by its concentration-dependent action and its tolerability and safety profile, but the available studies are inconclusive. Stratification is performed by groups of patients, on the recommendation of using doses above 6 mg/kg/day based on the PK/PD parameters predictive of efficacy and safety...
November 2013: Farmacia Hospitalaria
P Brandon Bookstaver, Christopher M Bland, Zaina P Qureshi, Carmen M Faulkner-Fennell, Margrit A Sheldon, Celeste R Caulder, Charles Hartis
STUDY OBJECTIVE: Data are limited for antimicrobial outcomes in obese patients. This study investigated the safety and clinical outcomes of daptomycin therapy in a hospitalized obese population in the southeastern United States. DESIGN: Multicenter retrospective cohort study. SETTING: Thirteen hospitals in the southeastern United States. PATIENTS: A total of 126 hospitalized adult obese patients (body mass index [BMI] more than 30 kg/m(2) ) admitted from January 2005 through May 2010 who received daptomycin dosed on actual body weight for any indication for a minimum of 7 days...
December 2013: Pharmacotherapy
Brett Janson, Karin Thursky
PURPOSE OF REVIEW: Obesity is becoming a major burden on healthcare systems worldwide. The management of infections is problematic due to both an increased risk of morbidity and mortality, as well as a lack of information about dosing of antibiotics in the obese population. Recommendations in this patient group are severely lacking, so clinicians need to consider pharmacokinetic/pharmacodynamic parameters and the relative risks of overdosing and underdosing. RECENT FINDINGS: Since 2011, articles on a number of antibiotics have been published, including cefazolin/cephazolin, cefepime, cefoxitin, clindamycin, cotrimoxazole, daptomycin, ertapenem, levofloxacin, linezolid, meropenem, moxifloxacin, piperacillin/tazobactam and vancomycin...
December 2012: Current Opinion in Infectious Diseases
Federico Pea, Piergiorgio Cojutti, Rodolfo Sbrojavacca, Barbara Cadeo, Francesco Cristini, Alessandro Bulfoni, Mario Furlanut
OBJECTIVE: To describe a case of severe cellulitis, successfully treated with high-dose daptomycin plus continuous infusion meropenem, in a patient with morbid obesity and renal failure, in whom drug exposure over time was optimized by means of real-time therapeutic drug monitoring (TDM). CASE SUMMARY: A 63-year-old man with morbid obesity (body mass index 81.6 kg/m²) and renal failure was admitted to the emergency department because of severe cellulitis. The patient had an admission Laboratory Risk Indicator for Necrotizing Fasciitis score of 9, and broad-spectrum antimicrobial therapy with daptomycin and meropenem was started...
July 2011: Annals of Pharmacotherapy
D A Figueroa, E Mangini, M Amodio-Groton, B Vardianos, A Melchert, C Fana, W Wehbeh, C M Urban, S Segal-Maurer
BACKGROUND: There are limited safety data for high-dose and long-term daptomycin treatment (16mg/kg administered for >or=14 days). We present our experience in 61 patients. METHODS: We performed a retrospective chart review for all patients treated with daptomycin at New York Hospital Queens (Flushing) from 1 January 2004 through 30 April 2007; patients were identified through a computerized hospital pharmacy database. RESULTS: Sixty-one patients (29 male and 32 female patients; mean age, 66...
July 15, 2009: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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