Pharmacokinetics of daptomycin in patients undergoing low-flow continuous venovenous hemodiafiltration

In daptomycin (DAP), 1,061 mg hour/l of the area under the concentration-time curve (AUC)/MIC was required to obtain clinical success [1], and a trough serum concentration (Cmin) cutoff point of 24.3 g/ml was most significantly associated with CPK elevation [2]. Reportedly, DAP at a recommended dosage of 8 mg/kg is removed in patients undergoing high-flow continuous venovenous hemodiafiltration (CVVHDF) (blood flow and filtration rates were 150 ± 48 and 2 l/hour). In Japan, CVVHDF is preferentially performed with lower flow rates. Investigating effects of flow rate on DAP removal during continuous renal replacement therapy is essential to adjust therapeutic dosages. We aimed to investigate the pharmacokinetics of DAP in CVVHDF patients in this setting.