Daptomycin
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Daptomycin Eosinophilia: case report A 63-year-old man developed peripheral eosinophilia during treatment with daptomycin for an infection of the knee. The man, who had a history of rheumatic fever during childhood, presented with left knee pain and swelling. Laboratory tests showed an initial WBC count of 16 500 /mm3 with 0 eosinophils. Blood cultures were obtained, and he received piperacillin/tazobactam and vancomycin. Findings from the blood cultures and aspiration cultures from his knee were positive for methicillin-sensitive Staphylococcus aureus. Piperacillin/ tazobactam and vancomycin were discontinued and he started treatment with nafcillin and gentamicin. He developed a rash that was thought to be associated with nafcillin on hospital day 7. Nafcillin and gentamicin were discontinued and he then received IV daptomycin 6 mg/kg every 48 hours. However, laboratory testing after 6 days of treatment with daptomycin revealed a WBC count of 7620 /mm3 with 11.8% eosinophils. The percentage of eosinophils peaked at 34.1% after 26 days of daptomycin treatment. He had no pulmonary symptoms and a chest xray was negative for effusions or infiltrates. His rash had resolved. Daptomycin was discontinued and the man received vancomycin. The peripheral eosinophilia resolved. Author comment: "Using the Naranjo et al. adverse-event probability scale, it was determined that daptomycin was the probable cause of eosinophilia in this patient (score of 6)." Doan TL, et al. Daptomycin-induced eosinophilia without pulmonary involvement. American Journal of Health-System Pharmacy 67: 2107-9, No. 24, 15 Dec 2010 803052696 USA
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Reactions 16 Apr 2011 No. 1347
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