Daptomycin-Induced Eosinophilic Pneumonia Treated With Intravenous Corticosteroids

Abstract

Since this potentially life-threatening adverse effect of daptomycin appears more common than previously reported, clinicians should have a high level of suspicion in any patient with recent daptomycin exposure who presents with pulmonary symptoms. In many cases, this process is highly responsive to prompt initiation of corticosteroid therapy.

Meropenem: A possible new culprit in eosinophilic lung diseases

“…A complete and updated list of drugs suspected of causing lung disease can be found on a website maintained by the Department of Pulmonary and Intensive Care at the University Hospital in Dijon, France with the following electronic address http://www.pneumotox.com . [ 6 7 ]…”

Daptomycin associated eosinophilic pneumonia: case report and differential diagnoses

“…DAEP is characteristically seen in elderly males and usually manifests as a febrile illness lasting a few weeks and is accompanied by constitutional symptoms, dyspnea and nonproductive cough [4,8]. Kim et al developed a case definition for DAEP and classified it as definite, probable, possible and unlikely based on fulfillment of criteria.…”

“…Pulmonary eosinophilic infiltrates or BAL eosinophilia is a cornerstone for diagnosis [2,9]. Discontinuation of daptomycin with or without corticosteroid is the mainstay of management [4,8]. Corticosteroid is believed to rapidly reverse the inflammation and thereby improve the hypoxia [8].…”

“…Corticosteroid is believed to rapidly reverse the inflammation and thereby improve the hypoxia [8]. Patients are usually started on intravenous methylprednisone 60–125 mg every 6–8 h, transitioned to oral prednisone 40–60 mg daily with clinical improvement and is tapered over 2–6 weeks to avoid relapse [8,10]. …”

Two patients with daptomycin induced eosinophilic pneumonia with different presentations and treatment

“…In general, patients developed eosinophilic pneumonia 2 to 4 weeks after starting daptomycin. But it could come earlier than that [8] , [9] . Our two patients presented to the hospital between the 3rd and 4th week after starting daptomycin and health care professionals should look for this complication any time after daptomycin is started.…”