Abstract
There is a paucity of data regarding efficacy and safety of concomitant therapy of daptomycin and statins, so we reviewed patients that concomitantly received daptomycin and statins to identify any potential increase in toxicity in our cohort. This retrospective study included all patients that received >6 mg/kg/day of daptomycin along with statins and had efficacy and safety data. Patients on high dose (>6 mg/kg/day) daptomycin therapy that did not received statins served as controls. One hundred four patients were included. Median daptomycin dose was 7.8 mg/kg/day (range 6.5–10.8 mg/kg/day), for a mean duration of therapy of 17 days (range 10–51 days). Thirty-six patients received daptomycin and statins and 68 received only daptomycin. Muscular toxicity defined as CPK levels > 1000 UI/L (2.5 times upper normal limit, range of determination 200–400 UI/L) was equally distributed between both groups (3/36, 8% vs 7/68, 10%; p = 0.746). Despite biochemical toxicity, we did not find clinical toxicity and daptomycin treatment was completed in all cases. We did not find predictors of increased CPK during daptomycin therapy. Based on our data, concomitant administration of daptomycin and statins is safe and is not associated with an increased risk of rhabdomyolysis.
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References
Baltz RH (2009) Daptomycin: mechanisms of action and resistance, and biosynthetic engineering. Curr Opin Chem Biol 13(2):144–151
Hobbs JK, Miller K, O'Neill AJ, Chopra I (2008) Consequences of daptomycin-mediated membrane damage in Staphylococcus aureus. J Antimicrob Chemother 62(5):1003–1008
Figueroa DA, Mangini E, Amodio-Groton M, Vardianos B, Melchert A, Fana C, Wehbeh W, Urban CM, Segal-Maurer S (2009) Safety of high-dose intravenous daptomycin treatment: three-year cumulative experience in a clinical program. Clin Infect Dis 49(2):177–180
Moise PA, Hershberger E, Amodio-Groton MI, Lamp KC (2009) Safety and clinical outcomes when utilizing high-dose (> or =8 mg/kg) daptomycin therapy. Ann Pharmacother 43(7):1211–1219
Parra-Ruiz J, Pena-Monje A, Tomas-Jimenez C, Pomares-Mora J, Hernandez-Quero J (2011) Efficacy and safety of high dose (>/=8 mg/kg/day) daptomycin. Enferm Infecc Microbiol Clin 29(6):425–427
Wu G, Abraham T, Rapp J, Vastey F, Saad N, Balmir E (2011) Daptomycin: evaluation of a high-dose treatment strategy. Int J Antimicrob Agents 38(3):192–196
Katz DE, Lindfield KC, Steenbergen JN, Benziger DP, Blackerby KJ, Knapp AG, Martone WJ (2008) A pilot study of high-dose short duration daptomycin for the treatment of patients with complicated skin and skin structure infections caused by gram-positive bacteria. Int J Clin Pract 62(9):1455–1464
Sauermann R, Rothenburger M, Graninger W, Joukhadar C (2008) Daptomycin: a review 4 years after first approval. Pharmacology 81(2):79–91
Pai MP, Norenberg JP, Anderson T, Goade DW, Rodvold KA, Telepak RA, Mercier RC (2007) Influence of morbid obesity on the single-dose pharmacokinetics of daptomycin. Antimicrob Agents Chemother 51(8):2741–2747
Hanley MJ, Abernethy DR, Greenblatt DJ (2010) Effect of obesity on the pharmacokinetics of drugs in humans. Clin Pharmacokinet 49(2):71–87
Fenton C, Keating GM, Curran MP (2004) Daptomycin. Drugs 64(4):445–455, discussion 457–448
Odero RO, Cleveland KO, Gelfand MS (2009) Rhabdomyolysis and acute renal failure associated with the co-administration of daptomycin and an HMG-CoA reductase inhibitor. J Antimicrob Chemother 63(6):1299–1300
Chang JT, Staffa JA, Parks M, Green L (2004) Rhabdomyolysis with HMG-CoA reductase inhibitors and gemfibrozil combination therapy. Pharmacoepidemiol Drug Saf 13(7):417–426
Farnier M (2011) Safety review of combination drugs for hyperlipidemia. Expert Opin Drug Saf 10(3):363–371
Kostrominova TY, Hassett CA, Rader EP, Davis C, Larkin LM, Coleman S, Oleson FB, Faulkner JA (2010) Characterization of skeletal muscle effects associated with daptomycin in rats. Muscle Nerve 42(3):385–393
Kostrominova TY, Coleman S, Oleson FB, Faulkner JA, Larkin LM (2010) Effect of daptomycin on primary rat muscle cell cultures in vitro. Vitro Cell Dev Biol Anim 46(7):613–618
Sirvent P, Mercier J, Lacampagne A (2008) New insights into mechanisms of statin-associated myotoxicity. Curr Opin Pharmacol 8(3):333–338
Berg ML, Estes L, Enzler MJ (2011) Effect of daptomycin with and without concurrent statin therapy on creatine phosphokinase (CPK) values. Abstract #A-1685, 51st ICAAC, Chicago, September 17–20
Bhavnani SM, Rubino CM, Ambrose PG, Drusano GL (2010) Daptomycin exposure and the probability of elevations in the creatine phosphokinase level: data from a randomized trial of patients with bacteremia and endocarditis. Clin Infect Dis 50(12):1568–1574
Crompton JA, North DS, McConnell SA, Lamp KC (2009) Safety and efficacy of daptomycin in the treatment of osteomyelitis: results from the CORE Registry. J Chemother 21(4):414–420
Chamberlain RS, Culshaw DL, Donovan BJ, Lamp KC (2009) Daptomycin for the treatment of surgical site infections. Surgery 146(2):316–324
Sakoulas G (2009) Clinical outcomes with daptomycin: a post-marketing, real-world evaluation. Clin Microbiol Infect 15(Suppl 6):11–16
Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ, Kaplan SL, Karchmer AW, Levine DP, Murray BE, Rybak MJ, Talan DA, Chambers HF (2011) Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children. Clin Infect Dis 52(3):e18–e55
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JPR has received honoraria, consultancy fees and funding research from Novartis, Pfizer and Astellas. JHQ has received honorary and consultancy fees from Novartis and Pfizer.
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Parra-Ruiz, J., Dueñas-Gutiérrez, C., Tomás-Jiménez, C. et al. Safety analysis of high dose (>6 mg/kg/day) daptomycin in patients with concomitant statin therapy. Eur J Clin Microbiol Infect Dis 31, 1771–1774 (2012). https://doi.org/10.1007/s10096-011-1500-y
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DOI: https://doi.org/10.1007/s10096-011-1500-y