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Metwali H1* and Elder K MD2
 
1 Clinical Pharmacist, Pharmaceutical Care Department at King Abdullah International Medical Research, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City –Jeddah, P.O. Box 9515, c/o pharmacy, Jeddah 21423, Saudi Arabia
2 pharmaceutical care department, Internal at King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical, National Guard Health Affeires, Jeddah, Saudi Arabia
 
*Correspondence: Metwali H, Pharm, Clinical Pharmacist, Pharmaceutical Care Department at King Abdullah International Medical Research, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City –Jeddah, P.O. Box 9515, c/o pharmacy, Jeddah 21423, Saudi Arabia, Tel: 966503375728, Email: hendmetwali@gmail.com

Received: 06-Sep-2018 Accepted Date: Sep 26, 2018 ; Published: 28-Sep-2018

Citation: Mettwali H, Elder K. Dose-independent daptomycin associated rhabdomyolysis: Case report. J Basic Clin Pharma October-2018;9(3): 286-288.

This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (http://creativecommons.org/licenses/by-nc/4.0/), which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes. For commercial reuse, contact reprints@jbclinpharm.org

Abstract

Background: Administration of Daptomycin may be associated with elevation in creatinine phosphokinase (CPK) level and increased risk of rhabdomyolysis with or without acute renal failure with a reported incidence of 2.8% in phase III clinical trials.

Case Presentation: We report the case of 70 years old male patient who had chronic vertebral osteomyelitis based on tissue (bone) culture, lumber spine MRI and abdominal CT. Daptomycin was started at a dose of 6 mg/kg intravenously once daily and continued at home thru Home Health Care (HHC) with baseline CPK=40 IU/L. After six days of treatment, CPK level elevated to 1254 IU/L. Despite initial improvement in CPK with reduction of Daptomycin dose, patient had to be re hospitalized again after 12 days of discharge with CPK level=15825 IU/L and acute kidney injury.

Conclusion: Daptomycin can be associated with elevations in CPK level and rhabdomyolysis despite reduction of dose. A baseline CPK level before starting Daptomycin treatment and more frequent monitoring in patients with additional risks, including renal impairment, is recommended.

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