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Organizing pneumonia and pulmonary eosinophilic infiltration associated with daptomycin

Elizabeth Cobb1, Robert C Kimbrough, Kenneth M Nugent

  • 1Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.

The Annals of Pharmacotherapy
|March 22, 2007
PubMed
Abstract

Insights

Daptomycin, an antibiotic, may cause organizing pneumonia with eosinophilic infiltrates in patients undergoing long-term treatment. This rare pulmonary reaction can manifest as lung nodules and infiltrates, resolving after drug discontinuation.

Area of Science:

  • Pulmonology
  • Pharmacology
  • Infectious Diseases

Background:

  • Daptomycin is a lipopeptide antibiotic commonly used for Gram-positive bacterial infections.
  • Adverse effects of daptomycin are generally mild, with pulmonary reactions being rare.
  • Organizing pneumonia is an idiopathic lung disease characterized by inflammation and fibrosis.

Observation:

  • An 84-year-old male developed bilateral lung nodules, infiltrates, and mediastinal lymphadenopathy during daptomycin therapy for a knee prosthesis infection.
  • Symptoms included weight loss, malaise, and weakness.
  • Transthoracic needle biopsy confirmed organizing pneumonia with eosinophilic infiltrates.

Findings:

  • The patient's condition improved after daptomycin was discontinued.
  • CT scan findings resolved within a month.
  • The Naranjo scale suggested a probable adverse drug reaction to daptomycin.

Implications:

  • This case suggests a potential association between chronic daptomycin use and organizing pneumonia with eosinophilic infiltrates.
  • Healthcare providers should consider daptomycin as a potential cause of new pulmonary infiltrates in patients on long-term therapy.
  • Further research is needed to elucidate the mechanism of this rare pulmonary reaction.

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