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: 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.
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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.