Cyclic Lipopeptide — MRSA / VRE / Bacteraemia / Endocarditis

Daptomycin

Brand names: Cubicin

Daptomycin is a cyclic lipopeptide antibacterial used for Gram-positive infections such as MRSA bacteraemia, right-sided infective endocarditis and complicated skin and soft-tissue infection. It is given once daily.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Adult Patients · Administer to adult patients intravenously in 0.9% sodium chloride, either by injection over a 2-minute period or by infusion over a 30-minute period. ( 2.1 , 2.7 ) · Recommended dosage regimen for adult patients ( 2.2 , 2.4 , 2.6 ): Creatinine Clearance (CL CR ) Dosage Regimen cSSSI For 7 to 14 days S.aureus Bacteremia For 2 to 6 weeks ≥30 mL/min 4 mg/kg once every 24 hours 6 mg/kg once every 24 hours <30 mL/min, including hemodialysis and CAPD 4 mg/kg once every 48 hours* 6 mg/kg once every 48 hours* *Administered following hemodialysis on hemodialysis days. Pediatric Patients • Unlike in adults, do NOT administer by injection over a two (2) minute period to pediatric …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2023-04-19. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It binds the bacterial cell membrane in a calcium-dependent manner, causing rapid depolarisation and loss of membrane potential, which produces concentration-dependent bactericidal activity against Gram-positive organisms.

Prescribing in practice

It must not be used to treat pneumonia, because pulmonary surfactant inactivates the drug and it is ineffective at the lung.
It can cause myopathy with raised creatine kinase, so creatine kinase should be monitored and concurrent statin therapy reviewed and, where appropriate, suspended.
Rarely it causes eosinophilic pneumonia, which should be suspected if new or worsening breathlessness, fever and eosinophilia develop, prompting discontinuation.

Monitoring

Monitor creatine kinase at baseline and at least weekly during treatment, more often if there is muscle toxicity risk; monitor renal function and watch for new respiratory symptoms. Use within an antimicrobial stewardship framework.

Counselling the patient

Report any muscle pain, weakness or tenderness promptly.
Report new breathlessness, cough or fever during treatment.
Mention any statin or other cholesterol medicine you take so it can be reviewed.

Evidence & guidelines

An established option for MRSA bacteraemia and right-sided endocarditis; it is not indicated for pneumonia. Use should follow local antimicrobial guidance.

Reference: IDSA MRSA Guidelines 2011; MHRA SPC Cubicin; TARGET Trial (Daptomycin vs Vancomycin for MRSA Bacteraemia); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways