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Antibiotics 2015, 4(3), 309-320;

Antimicrobial Stewardship Intervention and Feedback to Infectious Disease Specialists: A Case Study in High-Dose Daptomycin

Department of Pharmaceutical Services, University of New Mexico Hospital, 2211 Lomas Blvd NE, Albuquerque, NM 87106, USA
College of Pharmacy, University of New Mexico Health Sciences Center, MSC09 5360, 1 University of New Mexico, Albuquerque, NM 87131, USA
Division of Infectious Diseases, Department of Internal Medicine, 1 University of New Mexico, Albuquerque, NM 87131, USA
These authors contributed equally to this work.
Author to whom correspondence should be addressed.
Academic Editors: Jerod Nagel and Angela Huang
Received: 11 June 2015 / Accepted: 20 July 2015 / Published: 24 July 2015
(This article belongs to the Special Issue Antimicrobial Stewardship)
Full-Text   |   PDF [642 KB, uploaded 24 July 2015]   |  


Infectious Diseases specialists have used high-dose daptomycin (≥6 mg/kg/day) in select patients with difficult to treat methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) infections to optimize outcomes. Antimicrobial stewardship programs enforce antimicrobial formulary restrictions; however, interventions specifically aimed at Infectious Disease specialists can be particularly challenging. The purpose of this study was to create a high-dose daptomycin algorithm for Infectious Disease specialists that are consistent with best-practices. Daptomycin prescribing habits pre- and post-daptomycin algorithm implementation were evaluated using a quasi-experimental study design. Patients were included if ≥18 years of age and received daptomycin for ≥48 h. Patients were excluded if daptomycin was initiated on an outpatient setting. During the 12-month pre-intervention phase, 112 patients were included, with 73 patients in the 12-month post-intervention phase. A statistically significant decrease in the mean daptomycin dose from 9.01 mg/kg to 7.51 mg/kg (p < 0.005) was observed, resulting in an annual drug cost-savings of over $75,000 without adversely affecting readmission rates due to infection. Creation of a daptomycin algorithm with consideration of pathogen, disease state, and prior treatment, is an effective means of influencing prescribing habits of Infectious Disease specialists. View Full-Text
Keywords: antimicrobial stewardship; daptomycin; infectious diseases antimicrobial stewardship; daptomycin; infectious diseases

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Ross, J.L.; Rankin, S.; Marshik, P.; Mercier, R.-C.; Brett, M.; Walraven, C.J. Antimicrobial Stewardship Intervention and Feedback to Infectious Disease Specialists: A Case Study in High-Dose Daptomycin. Antibiotics 2015, 4, 309-320.

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