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FDA approved Daptomycin in Sodium Chloride Injection for Serious Gram-Positive InfectionsFDA approved New Form of Antibiotic for Serious Skin and Blood Infections

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The FDA has approved daptomycin in 0.9% sodium chloride injection, a lipopeptide antibacterial, for the treatment of complicated skin and skin structure infections (cSSSI) in adult and pediatric patients (1 to 17 years of age) for whom appropriate dosing can be achieved, and for Staphylococcus aureus bloodstream infections (bacteremia) in adult and pediatric patients (1 to 17 years), including adults with right-sided infective endocarditis. The approval provides a ready-to-use formulation of daptomycin, an agent active against Gram-positive pathogens including methicillin-resistant Staphylococcus aureus.

Clinically, daptomycin offers an option for serious Gram-positive infections, but its use is limited: it is not indicated for pneumonia or left-sided infective endocarditis due to S. aureus, and it is not recommended in pediatric patients younger than one year due to potential neuromuscular and nervous system effects observed in neonatal dogs. Dosing must be adjusted for renal function, and the product is only available in fixed doses of 350 mg, 500 mg, 700 mg, or 1,000 mg, which may not accommodate all weight-based regimens.

+ Clinical Details (Mechanism · Dosing · Trial Data · Warnings)
Mechanism of Action

Daptomycin is a lipopeptide antibacterial. The label does not provide a detailed mechanism of action.

Indication & Patient Population

Daptomycin in Sodium Chloride Injection is indicated for: - Complicated skin and skin structure infections (cSSSI) in adult and pediatric patients (1 to 17 years of age) for whom appropriate dosing can be achieved, caused by susceptible isolates of Staphylococcus aureus (including methicillin-resistant isolates), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus dysgalactiae subsp. equisimilis, and Enterococcus faecalis (vancomycin-susceptible isolates only). - Staphylococcus aureus bloodstream infections (bacteremia) in adult patients for whom appropriate dosing can be achieved, including those with right-sided infective endocarditis, caused by methicillin-susceptible and methicillin-resistant isolates. - Staphylococcus aureus bloodstream infections (bacteremia) in pediatric patients (1 to 17 years of age) for whom appropriate dosing can be achieved.

Limitations of Use: - Not indicated for the treatment of pneumonia. - Not indicated for the treatment of left-sided infective endocarditis due to S. aureus. Limited data from a clinical trial in adults with S. aureus bloodstream infections showed poor outcomes in patients with left-sided infective endocarditis. - Not studied in patients with prosthetic valve endocarditis. - Not recommended in pediatric patients younger than 1 year of age due to risk of potential effects on muscular, neuromuscular, and/or nervous systems observed in neonatal dogs.

Dosing & Administration

If a dose other than 350 mg, 500 mg, 700 mg, or 1,000 mg is required, this product is not recommended and an alternative daptomycin formulation should be considered.

Adult Patients: - Administer intravenously by infusion over a 30-minute period. - Dosage based on creatinine clearance (CLCR): - CLCR ≥30 mL/min: cSSSI: 4 mg/kg once every 24 hours for 7 to 14 days; S. aureus bacteremia: 6 mg/kg once every 24 hours for 2 to 6 weeks. - CLCR <30 mL/min, including hemodialysis and CAPD: cSSSI: 4 mg/kg once every 48 hours; S. aureus bacteremia: 6 mg/kg once every 48 hours. Administer following hemodialysis on hemodialysis days.

Pediatric Patients (1 to 17 years): - Administer intravenously by infusion over a 30- or 60-minute period, based on age. - For cSSSI, dosage by age: - 12 to 17 years: 5 mg/kg once every 24 hours infused over 30 minutes for up to 14 days. - 7 to 11 years: 7 mg/kg once every 24 hours infused over 30 minutes. - 2 to 6 years: 9 mg/kg once every 24 hours infused over 30 minutes. - 1 to less than 2 years: 10 mg/kg once every 24 hours infused over 60 minutes. - For S. aureus bacteremia in pediatric patients, the label does not provide specific dosing in the excerpt provided.

Key Clinical Trial Data

Trial data not available in label.

Warnings & Contraindications

The label excerpt does not list contraindications or detailed warnings. It notes that daptomycin is not indicated for pneumonia or left-sided infective endocarditis due to S. aureus, and is not recommended in pediatric patients younger than 1 year due to potential effects on muscular, neuromuscular, and/or nervous systems observed in neonatal dogs. No contraindications are reported in the provided text.

Place in Therapy

Daptomycin in Sodium Chloride Injection is an intravenous lipopeptide antibacterial for serious Gram-positive infections, including cSSSI and S. aureus bacteremia, including right-sided infective end

The FDA has approved a new form of an antibiotic called daptomycin, mixed in a saltwater solution. This medicine treats serious skin infections and a type of blood infection caused by Staphylococcus aureus, including a heart infection on the right side. It is for adults and children 1 to 17 years old. The new form is ready to use, which may save time for healthcare workers.

Daptomycin works against many Gram-positive bacteria, including MRSA, a common and hard-to-treat germ. This approval gives doctors another tool for these serious infections. However, it is not for all infections. It should not be used for pneumonia or for a heart infection on the left side caused by Staphylococcus aureus. It is also not recommended for children under 1 year old because of possible nerve and muscle effects seen in baby dogs.

The dose must be adjusted for kidney function, and the ready-to-use product comes only in fixed amounts: 350 mg, 500 mg, 700 mg, or 1,000 mg. That may not fit every patient's weight-based dose. If you or your child has a serious infection, talk with your doctor about whether this medicine is right for you. This news does not mean you should ask for this drug or change any treatment on your own.

What this means for you:
New antibiotic form approved for serious skin and blood infections, but only a doctor can decide if it is right for you.

Study Details

Study typeFda approval
PublishedJan 2022
View Original Abstract ↓
1 INDICATIONS AND USAGE Daptomycin in Sodium Chloride Injection is a lipopeptide antibacterial indicated for the treatment of: • Complicated skin and skin structure infections (cSSSI) in adult and pediatric patients (1 to 17 years of age) for whom appropriate dosing can be achieved ( 1.1 ) and, • Staphylococcus aureus bloodstream infections (bacteremia), in adult patients for whom appropriate dosing can be achieved, including those with right-sided infective endocarditis, ( 1.2 ) • Staphylococcus aureus bloodstream infections (bacteremia) in pediatric patients (1 to 17 years of age) for whom appropriate dosing can be achieved. ( 1.3 ) Limitations of Use • Daptomycin in Sodium Chloride Injection is not indicated for the treatment of pneumonia. ( 1.4 ) • Daptomycin in Sodium Chloride Injection is not indicated for the treatment of left-sided infective endocarditis due to S. aureus. ( 1.4 ) • Daptomycin in Sodium Chloride Injection is not recommended in pediatric patients younger than one year of age due to the risk of potential effects on muscular, neuromuscular, and/or nervous systems (either peripheral and/or central) observed in neonatal dogs. ( 1.4 ) To reduce the development of drug-resistant bacteria and maintain the effectiveness of Daptomycin in Sodium Chloride Injection and other antibacterial drugs, Daptomycin in Sodium Chloride Injection should be used to treat or prevent infections that are proven or strongly suspected to be caused by bacteria. ( 1.5 ) 1.1 Complicated Skin and Skin Structure Infections (cSSSI) Daptomycin in Sodium Chloride Injection is indicated for the treatment of adult and pediatric patients (1 to 17 years of age) for whom appropriate dosing can be achieved, with complicated skin and skin structure infections (cSSSI) caused by susceptible isolates of the following Gram-positive bacteria: Staphylococcus aureus (including methicillin-resistant isolates), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus dysgalactiae subsp. equisimilis, and Enterococcus faecalis (vancomycin-susceptible isolates only). 1.2 Staphylococcus aureus Bloodstream Infections (Bacteremia) in Adult Patients, Including Those with Right-Sided Infective Endocarditis, Caused by Methicillin-Susceptible and Methicillin-Resistant Isolates Daptomycin in Sodium Chloride Injection is indicated for the treatment of adult patients for whom appropriate dosing can be achieved, with Staphylococcus aureus bloodstream infections (bacteremia), including adult patients with right-sided infective endocarditis, caused by methicillin-susceptible and methicillin-resistant isolates. 1.3 Staphylococcus aureus Bloodstream Infections (Bacteremia) in Pediatric Patients (1 to 17 Years of Age) Daptomycin in Sodium Chloride Injection is indicated for the treatment of pediatric patients (1 to 17 years of age) for whom appropriate dosing can be achieved with Staphylococcus aureus bloodstream infections (bacteremia). 1.4 Limitations of Use Daptomycin in Sodium Chloride Injection is not indicated for the treatment of pneumonia. Daptomycin in Sodium Chloride Injection is not indicated for the treatment of left-sided infective endocarditis due to S. aureus . The clinical trial of daptomycin for injection in adult patients with S. aureus bloodstream infections included limited data from patients with left-sided infective endocarditis; outcomes in these patients were poor [see Clinical Studies (14.2) ]. Daptomycin for injection has not been studied in patients with prosthetic valve endocarditis. Daptomycin in Sodium Chloride Injection is not recommended in pediatric patients younger than 1 year of age due to the risk of potential effects on muscular, neuromuscular, and/or nervous systems (either peripheral and/or central) observed in neonatal dogs [see Warnings and Precautions (5.7) and Nonclinical Toxicology (13.2) ] . 1.5 Usage Appropriate specimens for microbiological examination should be obtained in order to isolate and identify the causative pathogens and to determine their susceptibility to daptomycin. To reduce the development of drug-resistant bacteria and maintain the effectiveness of Daptomycin in Sodium Chloride Injection and other antibacterial drugs, Daptomycin in Sodium Chloride Injection should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information is available, it should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. Empiric therapy may be initiated while awaiting test results.
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