Daptomycin is inactivated by pulmonary surfactant, so it fails in pneumonia even when the organism is susceptible. For MRSA pneumonia, use an agent that works in the lung.
It can cause myopathy and, rarely, rhabdomyolysis. Check creatine kinase at baseline and weekly, more often with renal impairment or a statin, and stop the drug if CK rises markedly with symptoms. Eosinophilic pneumonia is a rare but recognised reaction: new fever, breathlessness and infiltrates on daptomycin call for stopping it.
- Do not use daptomycin for pneumonia; surfactant inactivates it.
- Check creatine kinase at baseline and weekly during treatment.
- Consider pausing a statin during daptomycin therapy.
- Suspect eosinophilic pneumonia with new fever and infiltrates on treatment.
Why it matters
In-vitro susceptibility can mislead when the drug cannot work at the site of infection.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for infectious diseases, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free