FDA-approved
Skin & aging
Daptomycin
Daptomycin is an FDA-approved intravenous antibiotic for serious skin infections and Staph aureus bloodstream infections. Learn how it works and its uses.
- Reviewed by
- William Maish, MD MBA MPH, Clinical Product Lead
- Published
- October 5, 2026
- Last updated
- October 5, 2026
Key takeaway
Daptomycin (sold as Cubicin) is a cyclic lipopeptide antibiotic that kills Gram-positive bacteria, including MRSA, by puncturing their cell membrane. It is used for serious skin infections and for Staphylococcus aureus bloodstream infections, but notably not for pneumonia. It has been FDA-approved in the U.S. since 2003 and is given intravenously.
At a glance
| What it is | A cyclic lipopeptide antibiotic active against Gram-positive bacteria |
| Approved for | Complicated skin infections and S. aureus bloodstream infection, including right-sided endocarditis |
| Key fact | In a pivotal trial it was non-inferior to standard therapy for S. aureus bacteremia and endocarditis |
| Route | Intravenous |
| Evidence strength | FDA approved |
What is daptomycin?
Daptomycin, sold under the brand Cubicin, is a cyclic lipopeptide antibiotic with a fatty tail that lets it insert into bacterial membranes. It is active against Gram-positive organisms, including drug-resistant ones like MRSA and vancomycin-resistant enterococci, which makes it valuable when first-line options fail. It was developed under the code LY146032 and approved in the United States in 2003.
How does daptomycin work?
Daptomycin works at the bacterial cell membrane rather than the cell wall. In the presence of calcium, its lipid tail inserts into the Gram-positive membrane, where multiple molecules cluster to form channels. These channels let potassium and other ions leak out, rapidly collapsing the membrane's electrical charge. Without that charge the bacterium cannot sustain DNA, RNA, and protein synthesis, and it dies quickly, without bursting open.
That membrane mechanism gives concentration-dependent, rapid killing. One important limitation follows from its chemistry: daptomycin is inactivated by lung surfactant, so it does not work for pneumonia and is not used there. In the pivotal trial for bloodstream infection, daptomycin was non-inferior1 to standard therapy for S. aureus bacteremia and right-sided endocarditis, with less kidney dysfunction.
Is it FDA-approved?
Yes. Daptomycin was approved2 by the FDA in 2003 for complicated skin and skin-structure infections, with the S. aureus bloodstream infection indication (including right-sided endocarditis) added afterward. It is given once daily intravenously.
What is daptomycin prescribed for?
Daptomycin is prescribed for complicated skin and skin-structure infections and for S. aureus bloodstream infections, including right-sided infective endocarditis, caused by susceptible Gram-positive bacteria. It is explicitly not used for pneumonia.
What are the side effects?
According to the prescribing information, common side effects include:
- Diarrhea, headache, and dizziness
- Rash
- Abnormal liver tests and rises in the muscle enzyme CPK
- Urinary tract infections
- Low blood pressure and shortness of breath
More serious considerations include:
- Muscle injury (myopathy and rarely rhabdomyolysis), so CPK is monitored and statins may be paused
- Eosinophilic pneumonia, an uncommon lung reaction
- Peripheral neuropathy
- Serious allergic reactions, including a severe drug reaction called DRESS
- Kidney inflammation (tubulointerstitial nephritis)
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Sources: FDA prescribing information for Cubicin; a trial of daptomycin for S. aureus bacteremia and endocarditis (Fowler et al., The New England Journal of Medicine, 2006, DOI: 10.1056/NEJMoa0537831), indexed on PubMed. This document is educational and does not constitute medical advice.