Abstract
Background: Daptomycin-induced eosinophilic pneumonia (DEP) is a rare but severe adverse effect and the risk factors are unknown. The aim of this study was to determine risk factors for DEP. Methods: A retrospective cohort study was performed at the Bone and Joint Infection Unit of the Hospital Universitari Bellvitge (January 2014–December 2018). To identify risk factors for DEP, cases were divided into two groups: those who developed DEP and those without DEP. Results: Among the whole cohort (n = 229) we identified 11 DEP cases (4.8%) and this percentage almost doubled in the subgroup of patients ≥70 years (8.1%). The risk factors for DEP were age ≥70 years (HR 10.19, 95%CI 1.28–80.93), therapy >14 days (7.71, 1.98–30.09) and total cumulative dose of daptomycin ≥10 g (5.30, 1.14–24.66). Conclusions: Clinicians should monitor cumulative daptomycin dosage to minimize DEP risk, and be cautious particularly in older patients when the total dose of daptomycin exceeds 10 g.
Highlights
Daptomycin is a cyclic lipopeptide antibiotic approved for use against complicated skin and soft tissue infection, Staphylococcus aureus bacteremia and right-sided infective endocarditis
The performance of a chest X-ray significantly increased in accordance with the length of daptomycin therapy, ranging from 21% in cases treated less than 7 days to 42% in those treated more than 14 days (p = 0.005)
Among the remaining patients 3re. -Dcihscaullsesniogned with daptomycin, the eosinophilia was only observed at the prior exposure for foInutrhpe aptrieesnetnst (s1tu7d%y).we reported the main risk factors for developing Daptomycin-induced eosinophilic pneumonia (DEP) in a population with osteoarticular infections, providing important new information that may
Summary
Daptomycin is a cyclic lipopeptide antibiotic approved for use against complicated skin and soft tissue infection, Staphylococcus aureus bacteremia and right-sided infective endocarditis. Current guidelines advise for its use mainly as an initial induction course of intravenous antimicrobial therapy and often in combination with other antibiotics to avoid the appearance of resistance [1,2] In this setting, the use of daptomycin for prolonged periods should be balanced between the potential benefits in the outcome and the risk of adverse events [3,4,5]. Daptomycin has proven safety, daptomycin-induced eosinophilic pneumonia (DEP) is a rare but severe adverse effect [6,7]. Daptomycin-induced eosinophilic pneumonia (DEP) is a rare but severe adverse effect and the risk factors are unknown. Conclusions: Clinicians should monitor cumulative daptomycin dosage to minimize DEP risk, and be cautious in older patients when the total dose of daptomycin exceeds 10 g
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