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. 2023 May 13;12(5):904.
doi: 10.3390/antibiotics12050904.

Daptomycin Pharmacokinetics in Blood and Wound Fluid in Critical Ill Patients with Left Ventricle Assist Devices

Stefanie Calov  1 , Frederik Munzel  2 , Anka C Roehr  3 , Otto Frey  3 , Lina Maria Serna Higuita  4 , Petra Wied  1 , Peter Rosenberger  1 , Helene A Haeberle  1 , Kristian-Christos Ngamsri  1
Affiliations

Daptomycin Pharmacokinetics in Blood and Wound Fluid in Critical Ill Patients with Left Ventricle Assist Devices

Stefanie Calov et al. Antibiotics (Basel). .

Abstract

Daptomycin is a cyclic lipopeptide antibiotic with bactericidal effects against multidrug-resistant Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecalis (VRE). For critically ill patients, especially in the presence of implants, daptomycin is an important therapeutic option. Left ventricle assist devices (LVADs) can be utilized for intensive care patients with end-stage heart failure as a bridge to transplant. We conducted a single-center prospective trial with critically ill adults with LVAD who received prophylactic anti-infective therapy with daptomycin. Our study aimed to evaluate the pharmacokinetics of daptomycin in the blood serum and wound fluids after LVAD implantation. Daptomycin concentration were assessed over three days using high-performance liquid chromatography (HPLC). We detected a high correlation between blood serum and wound fluid daptomycin concentration at 12 h (IC95%: 0.64 to 0.95; r = 0.86; p < 0.001) and 24 h (IC95%: -0.38 to 0.92; r = 0.76; p < 0.001) after antibiotic administration. Our pilot clinical study provides new insights into the pharmacokinetics of daptomycin from the blood into wound fluids of critically ill patients with LVADs.

Keywords: cyclic lipopeptide antibiotic; daptomycin; left ventricle assist device; therapeutic drug monitoring.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Schematic illustration of the screening, excluding, enrolling, and including of the study participants. Created with BioRender.com.
Figure 2
Figure 2
Boxplots of daptomycin blood serum and wound fluid concentrations (mg/L) over three days. (A) The blood daptomycin concentration (orange) was detected one hour after intravenous administration or (B) after 12 or (C) 24 h for three consecutive days. The blue boxplots represent daptomycin in wound fluids at the indicated time points (n = 9/each group). Data presented as mean ± SD.
Figure 3
Figure 3
(A) Rmcorr correlation between the daptomycin concentration in blood serum (µg/mL) and wound fluid (µg/mL) after one hour, (B) 12, respectively, and (C) 24 h after intravenous daptomycin administration. Each point represents the correlation of each blood and wound fluid antibiotic concentration from all three postoperative days and each line represents the corresponding correlation.
See this image and copyright information in PMC

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