Dose-independent daptomycin associated rhabdomyolysis: Case report
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
Received Date: Sep 06, 2018 / Accepted Date: Sep 26, 2018 / Published Date: Sep 28, 2018
Citation: Mettwali H, Elder K. Dose-independent daptomycin associated rhabdomyolysis: Case report. J Basic Clin Pharma October-2018;9(3): 286-288.
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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.