UZH-Logo

Maintenance Infos

Therapeutic drug monitoring of daptomycin: a retrospective monocentric analysis


Reiber, Claudine; Senn, Oliver; Müller, Daniel; Kullak-Ublick, Gerd A; Corti, Natascia (2015). Therapeutic drug monitoring of daptomycin: a retrospective monocentric analysis. Therapeutic drug monitoring, 37(5):634-640.

Abstract

Background: Daptomycin dose is adjusted to body weight and renal function and is usually not guided by therapeutic drug monitoring (TDM). Daptomycin plasma concentration measurement was established at our institution in January 2009 and is now increasingly being used. The aim of this study was to describe and characterize variability in daptomycin exposure during routine clinical therapy.
Methods: We collected daptomycin plasma concentrations that were measured at our institution during the period January 2009-July 2012. Additional clinical and demographic data and their association with daptomycin exposure was tested by a multilevel linear regression analysis.
Results: A total of 332 daptomycin plasma concentrations were determined in 86 patients. 66% (n=218) of all determinations were trough concentrations (Cmin) and 34% (n=114) were peak concentrations (Cmax). Cmin ranged 2-68mg/L (median 16.7mg/L) and Cmax 20-236mg/L (median 66.2mg/L). A significant positive association of total dose, albumin, creatinine, and a significant negative association of dose interval and intermittent haemodialysis with Cmin was found in the regression analysis. Total dose and Intensive Care Unit (ICU)_-stay was significantly associated with Cmax (P<0.05). However, only 28% (P<0.005) of Cmin variability and 8% (P=0.08) of Cmax variability was explained by the factors included in the analysis.
Conclusion: Daptomycin plasma concentrations are often unpredictable as shown by highly variable drug exposure that is only partially explained by dose administered and underlying renal function.

Background: Daptomycin dose is adjusted to body weight and renal function and is usually not guided by therapeutic drug monitoring (TDM). Daptomycin plasma concentration measurement was established at our institution in January 2009 and is now increasingly being used. The aim of this study was to describe and characterize variability in daptomycin exposure during routine clinical therapy.
Methods: We collected daptomycin plasma concentrations that were measured at our institution during the period January 2009-July 2012. Additional clinical and demographic data and their association with daptomycin exposure was tested by a multilevel linear regression analysis.
Results: A total of 332 daptomycin plasma concentrations were determined in 86 patients. 66% (n=218) of all determinations were trough concentrations (Cmin) and 34% (n=114) were peak concentrations (Cmax). Cmin ranged 2-68mg/L (median 16.7mg/L) and Cmax 20-236mg/L (median 66.2mg/L). A significant positive association of total dose, albumin, creatinine, and a significant negative association of dose interval and intermittent haemodialysis with Cmin was found in the regression analysis. Total dose and Intensive Care Unit (ICU)_-stay was significantly associated with Cmax (P<0.05). However, only 28% (P<0.005) of Cmin variability and 8% (P=0.08) of Cmax variability was explained by the factors included in the analysis.
Conclusion: Daptomycin plasma concentrations are often unpredictable as shown by highly variable drug exposure that is only partially explained by dose administered and underlying renal function.

Citations

2 citations in Web of Science®
1 citation in Scopus®
Google Scholar™

Altmetrics

Downloads

39 downloads since deposited on 07 Jul 2015
31 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of Clinical Chemistry
04 Faculty of Medicine > University Hospital Zurich > Clinic for Clinical Pharmacology and Toxicology
04 Faculty of Medicine > University Hospital Zurich > Institute of General Practice
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2015
Deposited On:07 Jul 2015 11:47
Last Modified:01 Nov 2016 01:00
Publisher:Lippincott Williams & Wilkins
ISSN:0163-4356
Additional Information:This is a non-final version of an article published in final form in
Publisher DOI:https://doi.org/10.1097/FTD.0000000000000196
PubMed ID:26384039
Permanent URL: https://doi.org/10.5167/uzh-111241

Download

[img]
Preview
Content: Accepted Version
Filetype: PDF
Size: 280kB
View at publisher
[img]
Preview
Content: Published Version
Filetype: PDF
Size: 278kB

TrendTerms

TrendTerms displays relevant terms of the abstract of this publication and related documents on a map. The terms and their relations were extracted from ZORA using word statistics. Their timelines are taken from ZORA as well. The bubble size of a term is proportional to the number of documents where the term occurs. Red, orange, yellow and green colors are used for terms that occur in the current document; red indicates high interlinkedness of a term with other terms, orange, yellow and green decreasing interlinkedness. Blue is used for terms that have a relation with the terms in this document, but occur in other documents.
You can navigate and zoom the map. Mouse-hovering a term displays its timeline, clicking it yields the associated documents.

Author Collaborations