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Elevated creatine phosphokinase levels associated with linezolid therapy.
Glenn W Allison1, Rocco J Perla, Paul P Belliveau
1Quality and Safety, Hospital Medicine Program, MetroWest Medical Center, Framingham, MA 01702, USA. glenn.allison@mwmc.com
Summary
Linezolid therapy may cause elevated creatine phosphokinase (CPK) levels, even in patients on antihyperlipidemic medications. This case highlights a potential drug-induced elevation in CPK associated with linezolid use.
Area of Science:
- Pharmacology
- Clinical Medicine
- Toxicology
Background:
- A 79-year-old male patient with hyperlipidemia, treated with lovastatin and gemfibrozil, was admitted for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia.
- Initial treatment with vancomycin was switched to linezolid due to lack of response.
Observation:
- The patient developed significantly elevated creatine phosphokinase (CPK) levels after initiating linezolid therapy.
- CPK levels continued to rise even after discontinuation of antihyperlipidemic drugs.
Findings:
- CPK levels rapidly normalized after linezolid was discontinued, suggesting a causal association.
- The temporal relationship strongly indicates linezolid as the likely cause of the elevated CPK levels.
Implications:
- Clinicians should monitor CPK levels in patients receiving linezolid, particularly those on antihyperlipidemic therapy.
- This case underscores the potential for linezolid-induced myopathy and the importance of considering drug interactions.
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