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Daptomycin-induced hyperkalemia in a patient with normal renal function.

Aliaksandr Budovich1, Sharon Blum2, Barbara Berger2

  • 1Aliaksandr Budovich, Pharm.D., is Postgraduate Year 1 Pharmacy Practice Resident; Sharon Blum, Pharm.D., is Infectious Disease Specialist; and Barbara Berger, M.D., FACP, is Infectious Disease Specialist, Brookdale University Hospital and Medical Center, Brooklyn, NY. abudovich@gmail.com.

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Summary

This case report details episodic hyperkalemia in a patient treated with daptomycin. The study highlights a likely adverse reaction to daptomycin, even in patients with normal renal function.

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Area of Science:

  • Pharmacology
  • Nephrology
  • Clinical Medicine

Background:

  • Daptomycin is an antibiotic used for serious Gram-positive bacterial infections.
  • Hyperkalemia is a condition characterized by elevated serum potassium levels, which can have serious cardiac implications.

Observation:

  • A 46-year-old woman with normal renal function developed elevated serum potassium levels during daptomycin therapy for a shoulder abscess.
  • The hyperkalemia episodes showed a close temporal relationship with daptomycin administration and resolved upon drug discontinuation.

Findings:

  • The patient experienced recurrent hyperkalemia, with serum potassium levels rising to 6.1 meq/L.
  • Rechallenge with daptomycin at a reduced dose led to another increase in potassium levels, suggesting a probable adverse drug reaction.
  • This is the first reported case of hyperkalemia associated with daptomycin in a patient with normal renal function.

Implications:

  • Clinicians should monitor serum potassium levels in patients receiving daptomycin, particularly at higher doses.
  • This case suggests a potential link between daptomycin and hyperkalemia, necessitating further investigation.
  • Awareness of this potential adverse effect is crucial for patient safety and effective antibiotic management.