From the FDA Drug Label
Daptomycin has been shown to be active against most isolates of the following microorganisms both in vitro and in clinical infections At least 90 percent of the following bacteria exhibit an in vitro minimum inhibitory concentration (MIC) less than or equal to the susceptible breakpoint for daptomycin against isolates of similar genus or organism group. Gram-Positive Bacteria Staphylococcus epidermidis (including methicillin-resistant isolates)
Daptomycin is effective against Staphylococcus epidermidis (including methicillin-resistant isolates) 1.
From the Research
For treating Staphylococcus epidermidis infections, the first-line antibiotic is typically vancomycin, administered at 15-20 mg/kg IV every 8-12 hours for serious infections, as supported by the most recent study 2. When considering treatment options, it's essential to note that S. epidermidis frequently carries methicillin resistance (MRSE), making beta-lactams like oxacillin or cefazolin less reliable choices 3, 4. Some key points to consider in treatment include:
- Treatment duration varies based on infection site and severity, with skin infections typically requiring 7-10 days while bloodstream or prosthetic device infections may need 2-6 weeks 5.
- Antibiotic susceptibility testing is crucial for guiding therapy since resistance patterns vary widely 3, 4.
- S. epidermidis commonly forms biofilms on medical devices, which may necessitate device removal alongside antibiotic therapy for complete eradication of the infection 4, 2. For less severe infections, oral options may be considered, but the primary choice remains vancomycin due to its efficacy against methicillin-resistant strains 3, 5. In cases where vancomycin is not suitable, or the infection persists, salvage combination therapy regimes such as daptomycin with ceftaroline may be considered 2. It's also worth noting that newer agents and some older ones show good activity against resistant staphylococci, including trimethoprim-sulfamethoxazole, ceftaroline, daptomycin, fosfomycin, linezolid, dalbavancin, televancin, and omadacycline 5, but vancomycin remains the standard of care for the treatment of resistant staphylococcal infections 5.