Abstract
PurposeEosinophilic pneumonia comprises a group of lung diseases in which eosinophils appear in increased numbers in the lungs and sometimes in the bloodstream. Several case reports link daptomycin use to this phenomenon.SummaryWe performed a systematic literature review to identify cases of eosinophilic pneumonia associated with daptomycin use. Relevant studies were identified by searching Pubmed/Medline, EMBASE, Google Scholar, Cochrane Database of Systematic Reviews, and Clin-Alert from inception to May 2016, and manual searches of reference lists. All case reports that include information regarding patient age, indication, clinical and objective findings, treatment and outcome were evaluated. s from conference proceedings as well as case reports not in English were excluded. Descriptive statistics were used to analyze the data. Thirty-five patient-cases were included in the final analysis. Patients most likely to be identified with daptomycin-induced eosinophilic pneumonia were male (83%) and elderly (mean age 65.4 ± 15 years). The dose for daptomycin ranged from 4 to 10 mg/kg/day, but included a large number of patients with renal dysfunction. The average duration of daptomycin therapy upon onset of EP symptoms was 2.8 ± 1.6 weeks. Majority of patients presented with dyspnea (94%), fever (57%) and were also found to have peripheral eosinophilia (77%) and infiltrates/opacities of CT/CXR (86%). Symptom improvement was seen after daptomycin discontinuation (24 h to 1 week). The majority of patients were also prescribed treatment with corticosteroids (66%).ConclusionClinicians should be aware of daptomycin-induced eosinophilic pneumonia and its symptoms along with its presentation and treatment.
Highlights
Eosinophilic pneumonia is a rare, but serious respiratory syndrome that occurs when eosinophils accumulate in the lungs [1, 2]
Clinicians should be aware of daptomycin-induced eosinophilic pneumonia and its symptoms along with its presentation and treatment
The pathophysiology of acute eosinophilic pneumonia is thought to be caused by detection of an antigen by alveolar macrophages which leads to recruitment of T-helper 2 lymphocytes and subsequent release of interleukin 5
Summary
Eosinophilic pneumonia is a rare, but serious respiratory syndrome that occurs when eosinophils accumulate in the lungs [1, 2]. It has been associated with several medications and chemicals, with antibiotics and nonsteroidal anti-inflammatory drugs among the most common [3, 4]. Interleukin 5 promotes eosinophil production and migration to the lung. Eotaxin (a potent eosinophil chemoattractant) production by alveolar macrophages, pulmonary endothelial cells, airway smooth muscle cells, Daptomycin is a cyclic lipopeptide antibiotic derived from the fermentation of Streptomyces roseosporus.
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