High-dose, short-interval daptomycin regimen was safe and well tolerated in three patients with chronic renal failure
A 75-year-old woman admitted to stabilize chronic heart failure was found to have MRSA bacteremia. Teicoplanin was started, but she complained of lumbago, and osteomyelitis was also found on magnetic resonance imaging. Therefore, treatment was changed to linezolid because better tissue penetration was expected (). However, platelets decreased to less than 1 × 105 cells/μL (4.3 × 104) as an adverse effect of linezolid, and so we were consulted on day 28. Because of the results from the patient described in case 1, who did not show an increase of CPK and creatinine, we suggested a change to daptomycin 6.2 mg/kg daily under close observation, in spite of her renal function (creatinine clearance 19.1 mL per minute). One month later, no adverse effects, including no elevation of CPK and creatinine, had occurred, and daptomycin therapy was clinically eifficacious.