Presentation & History Helen is a 71-year-old obese, diabetic white female with a chief complaint of extreme pain near her right ankle over the past 2 weeks. She has noted an ulcer at the site, accompanied by radiating pain and swelling. She has covered the site with sterile bandages.

Past medical history is significant for varicose vein surgery 3 years ago in the area of her right leg below the knee and above the ankle. Medications include hypoglycemics to manage her diabetes.

With the onset of pain, she self-medicated with aspirin and daily leg elevation.

Examination: temperature 100.6°F, pulse 92, RR 16, BP 110/68, obese female in no acute distress

• Lungs: clear to auscultation, bilaterally
• Heart: no murmurs, rubs, or gallops
• Abdomen: soft, nontender
• Extremities: limbs cool to touch, abnormal pedal pulses; ulcer has clearly demarcated border with exposure of ankle tendon, pitting edema, and venous dermatitis

Transcutaneous oxygen measurement confirms poor arterial flow to the right leg.

The initial diagnosis is a stasis ulcer with infection presumptively due to MRSA.

This patient was initially started on vancomycin; however, at 48 hours no improvement was seen upon visual inspection of the infection site.

This profile is for educational purposes only and is not based on an actual patient.
Actual diagnoses and treatments must be determined by attending physicians.

Proven clinical success of CUBICIN 4 mg/kg once daily in complicated skin infections, including MRSA and MSSA1†


CUBICIN once daily for complicated skin infections and bacteremia caused by S. aureus


CLCR = creatinine clearance; CAPD = continuous ambulatory peritoneal dialysis.

• Once daily 30-minute, 50-mL infusion
• No required monitoring of drug level in blood
• Low potential for drug-drug interactions (not metabolized via CYP450)
  • No known drug-drug interactions with selective serotonin reuptake inhibitors

Reference: 1. Arbeit RD, Maki D, Tally FP, Campanaro E, Eisenstein BI. The safety and efficacy of daptomycin for the treatment of complicated skin and skin structure infections. Clin Infect Dis. 2004;38:1673-1681.

Presentation & History Angela is a 47-year-old Hispanic female with a history of recurrent foot ulcers. She presents with an open wound on her left foot that developed 3 weeks ago. The patient reports pain in the area. Purulent discharge is present upon pressure to the affected area.

• Prior hospitalization 6 months ago for a similar ulcerated infection of the foot
  • Vancomycin administered in-patient
  • Discharged on oral antibiotic therapy
  • Physician reports that patient may have been noncompliant with oral therapy
• History of diabetes, depression, and hypertension
  • Medications include an oral hypoglycemic, a selective serotonin reuptake inhibitor (SSRI), and an antihypertensive
• Examination: temperature 100.7°F, pulse 90, RR 16, BP 135/80, middle-aged female
  • Lungs: clear to auscultation, bilaterally
  • Heart: S3 gallop, regular rhythm
  • HEENT: pupils reactive, no lesions
  • Extremities: decreased sensation to light touch in both feet; 1+ pitting, pretibial edema, bilaterally; dorsalis pedis pulse palpable, but weak; 3.5-cm erosive lesion on the side of the first metatarsophalangeal joint, with purulent discharge, erythema, and tenderness

A wound culture of the site showed Gram-positive cocci.

The presumptive diagnosis is MRSA complicated skin infection.

• Patient reports concern for maintaining her work and personal schedules
• Physician and patient agree home infusion therapy is an appropriate choice for managing this infection

This profile is for educational purposes only and is not based on an actual patient.
Actual diagnoses and treatments must be determined by attending physicians.

Proven clinical success of CUBICIN 4 mg/kg once daily in complicated skin infections, including MRSA and MSSA1*


CUBICIN once daily for complicated skin infections and bacteremia caused by S. aureus


CLCR = creatinine clearance; CAPD = continuous ambulatory peritoneal dialysis.

• Once daily 30-minute, 50-mL infusion
• No required monitoring of drug level in blood
• Can be given by peripheral line, midline, or peripherally inserted central catheter
• Low potential for drug-drug interactions (not metabolized via CYP450)
  • No known drug-drug interactions with SSRIs
• Permanent J-code reimbursement: J0878
  • 24-hour hotline: 1-866-RX-DAPTO

References: 1. Arbeit RD, Maki D, Tally FP, Campanaro E, Eisenstein BI. The safety and efficacy of daptomycin for Clin Infect Dis. 2004;38:1673-1681. The treatment of complicated skin and skin structure infections. 2. Silverman JA, Perlmutter NG, Shapiro HM. Correlation of daptomycin bactericidal activity and membrane depolarization in Staphylococcus aureus. Antimicrob Agents Chemother. 2003;47:2538-2544.