• Type: bacterial antibiotic
  • Dosage Forms: IV
  • Common Trade Names: Cubicin
  • Good soft tissue and MSK penetration, but poor lung penetration as it is inactivated by pulmonary surfactant[1][2]

Adult Dosing

  • Complicated bacterial skin infections:
    • 4mg/kg q24h x7-14 days
  • Staph bacteremia:
    • 6mg/kg IV q24h x2-6 wks
  • Renal dosing
    • CrCl <30, give q48h
    • HD: give dose after dialysis, no supplement
    • PD: no supplement

Pediatric Dosing

  • Unavailable

Special Populations

  • Pregnancy Rating: B
  • Lactation: Infant risk cannot be ruled out
  • Renal Dosing
    • Adult
    • Pediatric
  • Hepatic Dosing
    • Adult
    • Pediatric


  • Allergy to class/drug
  • CK > 10x upper limit normal
  • CK > 10x upper limit normal with myopathy
  • caution in elderly
  • caution in recent antibiotic-associated colitis

Adverse Reactions


  • C. difficile diarrhea
  • Superinfection
  • Eosinophilic pneumonia
  • Anaphylaxis
  • Drug rash
  • Thrombocytopenia
  • Myopathy
  • Rhabdomyolysis
  • Peripheral neuropathy


  • Insomnia
  • Pharyngeal pain
  • Elevated CK
  • Chest pain
  • Edema
  • Abdominal pain
  • Pruritis
  • Headache
  • Diarrhea


  • Half-life: 8-9 h
  • Metabolism: unknown
  • Excretion: Urine 78%
  • Mechanism of Action: Bactericidal, binds/depolarizes bacterial membranes

Antibiotic Sensitivities[4]

Group Organism Sensitivity
Gram PositiveStrep. Group A, B, C, GS
Strep. PneumoniaeX23
Viridans strepX1
Strep. anginosus gpX1
Enterococcus faecalisS
Enterococcus faeciumS
Staph. EpidermidisS
C. jeikeiumS
L. monocytogenesI
Gram NegativesN. gonorrhoeaeR
N. meningitidisR
Moraxella catarrhalisR
H. influenzaeR
E. coliR
Klebsiella spR
E. coli/Klebsiella ESBL+R
E coli/Klebsiella KPC+R
Enterobacter sp, AmpC negR
Enterobacter sp, AmpC posR
Serratia spX1
Serratia marcescensR
Salmonella spR
Shigella spX1
Proteus mirabilisX1
Proteus vulgarisR
Providencia sp.X1
Morganella sp.X1
Citrobacter freundiiX1
Citrobacter diversusX1
Citrobacter sp.X1
Aeromonas spX1
Acinetobacter sp.R
Pseudomonas aeruginosaR
Burkholderia cepaciaR
Stenotrophomonas maltophiliaR
Yersinia enterocoliticaR
Francisella tularensisR
Brucella sp.R
Legionella sp.R
Pasteurella multocidaX1
Haemophilus ducreyiR
Vibrio vulnificusR
MiscChlamydophila spX1
Mycoplasm pneumoniaeX1
Rickettsia spX1
Mycobacterium aviumX1
Bacteroides fragilisX1
Prevotella melaninogenicaX1
Clostridium difficileX1
Clostridium (not difficile)X1
Fusobacterium necrophorumX1
Peptostreptococcus sp.X1


  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia


  1. Estes KS and Derendorf K. Comparison of the pharmacokinetic properties of vancomycin, linezolid, tigecyclin, and daptomycin. Eur J Med Res. 2010; 15(12): 533–543.
  2. Silverman JA et al. Inhibition of Daptomycin by Pulmonary Surfactant: In Vitro Modeling and Clinical Impact. J Infect Dis. (2005) 191 (12): 2149-2152.
  3. Stein GE and Wells EM. The importance of tissue penetration in achieving successful antimicrobial treatment of nosocomial pneumonia and complicated skin and soft-tissue infections caused by methicillin-resistant Staphylococcus aureus: vancomycin and linezolid. Curr Med Res Opin. 2010 Mar;26(3):571-88.
  4. Sanford Guide to Antimicrobial Therapy 2014
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