Daptomycin serum levels in critical patients undergoing continuous renal replacement

Background: Daptomycin pharmacokinetics has not been extensively studied in patients undergoing continuous renal replacement therapy (CRRT). Methods: The aim of the study was to collect pharmacokinetics and clinical data of patients undergoing CRRT and receiving daptomycin therapy. Daptomycin was measured using an isocratic high-performance liquid chromatography technique. Results: Three patients with bloodstream infection underwent CVVHD and three CVVHDF. CVVHDF patients had significantly lower mean AUC(0-24) and C-max values. A significant decrease in plasma levels was observed in a CVVHDF patient using 'high cut-off' hemofilters. Conclusion: Increasing doses of daptomycin should be considered in critical patients, especially those undergoing CVVHDF.