Is daptomycin administered intravenously (IV) or orally?

Daptomycin Administration Route

Daptomycin is exclusively administered intravenously (IV) and is not available in oral formulation. 1, 2

Administration Details

• Daptomycin is only available as an intravenous medication, typically dosed at 4-6 mg/kg once daily for adults, depending on the type of infection being treated 1
• It is supplied as a sterile, lyophilized powder in single-dose vials containing 500 mg daptomycin that must be reconstituted with 0.9% sodium chloride injection to a concentration of 50 mg/mL 1
• For adults, daptomycin can be administered as either:
  • Intravenous injection over a 2-minute period 1
  • Intravenous infusion over a 30-minute period 1

Clinical Applications

• Daptomycin is approved for complicated skin and soft tissue infections (cSSTIs) at 4 mg/kg IV once daily 3, 4
• For Staphylococcus aureus bloodstream infections (bacteremia) including right-sided endocarditis, the approved dose is 6 mg/kg IV once daily 3, 4
• In the treatment of MRSA infections, daptomycin is listed among the intravenous options at a dose of 4-6 mg/kg IV every 24 hours 2

Special Populations

• For patients with renal impairment (CrCl <30 mL/min), including those on hemodialysis, the dosing interval is extended to every 48 hours while maintaining the same per-dose amount 1, 5
• For pediatric patients (7-17 years), daptomycin must be administered as an intravenous infusion over 30 minutes 1
• For younger pediatric patients (1-6 years), the infusion should be administered over 60 minutes 1

Important Considerations

• Daptomycin is incompatible with dextrose-containing diluents 1
• The reconstituted solution is stable for 12 hours at room temperature and up to 48 hours if refrigerated at 2-8°C 1
• When treating severe infections, higher doses of daptomycin (up to 10-12 mg/kg) have been studied and may be considered for difficult-to-treat infections 3, 6

Comparison with Other Antimicrobials

• Unlike some antibiotics such as linezolid and tedizolid which are available in both IV and oral formulations, daptomycin is only available for IV administration 2
• In guidelines for skin and soft tissue infections, daptomycin is consistently listed under "Intravenous options" rather than "Oral options" 2

Daptomycin's unique mechanism of action as a cyclic lipopeptide and its rapid, concentration-dependent bactericidal activity make it valuable for treating serious gram-positive infections, but its administration is limited to the intravenous route only 7.