Dose-independent daptomycin associated rhabdomyolysis: Case report

Metwali H; Elder K

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, Email: [email protected]

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.