From the Guidelines
Daptomycin is effective against Streptococcus pyogenes, as indicated by the 2014 practice guidelines for the diagnosis and management of skin and soft tissue infections by the Infectious Diseases Society of America 1. The guidelines list daptomycin as an alternative treatment option for streptococcal skin infections, along with other antibiotics such as clindamycin, vancomycin, linezolid, and telavancin.
- Key points to consider when using daptomycin for S. pyogenes infections include:
- Daptomycin's mechanism of action, which involves binding to bacterial cell membranes and causing rapid depolarization and inhibition of protein, DNA, and RNA synthesis, leading to bacterial cell death.
- The typical adult dosage for skin infections, which is 4 mg/kg IV once daily, and for bacteremia, which is 6 mg/kg IV once daily, as per standard treatment protocols.
- The importance of monitoring creatine phosphokinase levels weekly during therapy due to potential muscle toxicity, as well as being aware that daptomycin is inactivated by pulmonary surfactant, making it ineffective for treating pneumonia.
- It is essential to note that while daptomycin is effective against S. pyogenes, its use should be guided by the severity and site of infection, as well as local resistance patterns, and treatment duration typically ranges from 7-14 days, as indicated by clinical guidelines and expert recommendations 1.
From the FDA Drug Label
Daptomycin for injection is indicated for the treatment of adult and pediatric patients (1 to 17 years of age) 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).
Daptomycin covers Streptococcus pyogenes, as it is listed as one of the susceptible Gram-positive bacteria for the treatment of complicated skin and skin structure infections (cSSSI) 2.
- Key points:
- Daptomycin is indicated for cSSSI caused by Streptococcus pyogenes
- The drug label explicitly lists Streptococcus pyogenes as a susceptible bacteria
- Daptomycin should be used to treat infections proven or strongly suspected to be caused by susceptible bacteria, including Streptococcus pyogenes 2
From the Research
Daptomycin Coverage
- Daptomycin is effective against Gram-positive pathogens, including Streptococcus pyogenes 3, 4, 5.
- The antibiotic has been approved for use in the treatment of complicated skin and skin structure infections caused by S. pyogenes, among other Gram-positive cocci 3, 4.
- Studies have shown that daptomycin has rapid, concentration-dependent bactericidal activity against S. pyogenes 4, 5.
- Daptomycin is also active against other beta-hemolytic streptococci, including S. agalactiae and S. dysgalactiae subsp. equisimilis 3, 4.
Spectrum of Activity
- Daptomycin's spectrum of activity includes methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecalis, and Enterococcus faecium 3, 6.
- The antibiotic has been shown to be effective against a wide range of Gram-positive bacteria, making it a valuable treatment option for complicated skin and skin structure infections 3, 4, 5, 6.
Clinical Use
- Daptomycin is administered intravenously, with a recommended dose of 4 mg/kg once daily for the treatment of complicated skin and skin structure infections 3, 4.
- The antibiotic has a favorable safety profile, with a low potential for resistance and a relatively prolonged concentration-dependent postantibiotic effect in vitro 3, 4.