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daptomycin was removed from the world health organization’s list of essential medicines in 2019. the world health organization classifies daptomycin as critically important for human medicine.

medical uses
daptomycin is indicated for use in adults in the united states for skin and skin structure infections caused by gram-positive infections, s. aureus bacteraemia, and right-sided s. aureus endocarditis. it binds avidly to pulmonary surfactant, so cannot be used in the treatment of pneumonia. there seems to be a difference in working daptomycin on hematogenous pneumonia.

adverse effects
common adverse drug reactions associated with daptomycin therapy include:

cardiovascular: low blood pressure, high blood pressure, swelling
central nervous system: insomnia
dermatological: rash
gastrointestinal: diarrhea, abdominal pain
hematological: eosinophilia
respiratory: dyspnea
other: injection site reactions, fever, hypersensitivity
less common, but serious adverse events reported in the literature include

hepatotoxicity: elevated transaminases
nephrotoxicity: acute kidney injury from rhabdomyolysis
also, myopathy and rhabdomyolysis have been reported in patients simultaneously taking statins, but whether this is due entirely to the statin or whether daptomycin potentiates this effect is unknown. due to the limited data available, the manufacturer recommends that statins be temporarily discontinued while the patient is receiving daptomycin therapy. creatine kinase levels are usually checked regularly while individuals undergo daptomycin therapy.

in july 2010, the fda issued a warning that daptomycin could cause life-threatening eosinophilic pneumonia. the fda said it had identified seven confirmed cases of eosinophilic pneumonia between 2004 and 2010 and an additional 36 possible cases. the seven confirmed victims were all older than 60 and symptoms appeared within two weeks of initiation of therapy.

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