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Musculoskeletal safety outcomes of patients receiving daptomycin with HMG-CoA reductase inhibitors.
Antimicrob Agents Chemother. 2014 Oct; 58(10):5726-31.AA

Abstract

Daptomycin, a cyclic lipopeptide antibiotic, and 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) are commonly administered in the inpatient setting and are associated with creatine phosphokinase (CPK) elevations, myalgias, and muscle weakness. Safety data for coadministration of daptomycin with statins are limited. To determine the safety of coadministration of daptomycin with statin therapy, a multicenter, retrospective, observational study was performed at 13 institutions in the Southeastern United States. Forty-nine adult patients receiving statins concurrently with daptomycin were compared with 171 patients receiving daptomycin without statin therapy. Detailed information, including treatment indication and duration, infecting pathogen, baseline and subsequent CPK levels, and presence of myalgias or muscle complaints, was collected. Myalgias were noted in 3/49 (6.1%) patients receiving combination therapy compared with 5/171 (2.9%) of patients receiving daptomycin alone (P = 0.38). CPK elevations of >1,000 U/liter occurred in 5/49 (10.2%) patients receiving combination therapy compared to 9/171 (5.3%) patients receiving daptomycin alone (P = 0.32). Two of five patients experiencing CPK elevations of >1,000 U/liter in the combination group had symptoms of myopathy. Three patients (6.1%) discontinued therapy due to CPK elevations with concurrent myalgias in the combination group versus 6 patients (3.5%) in the daptomycin-alone group (P = 0.42). CPK levels and myalgias reversed upon discontinuation of daptomycin therapy. Overall musculoskeletal toxicity was numerically higher in the combination group but this result was not statistically significant. Further prospective study is warranted in a larger population.

Authors+Show Affiliations

Department of Clinical Pharmacy, Dwight D. Eisenhower Army Medical Center, Fort Gordon, Georgia, USA Department of Clinical Pharmacy & Outcomes Sciences, South Carolina College of Pharmacy at the University of South Carolina, Columbia, South Carolina, USA chris.bland@us.army.mil.Department of Clinical Pharmacy & Outcomes Sciences, South Carolina College of Pharmacy at the University of South Carolina, Columbia, South Carolina, USA.Department of Clinical Pharmacy & Outcomes Sciences, South Carolina College of Pharmacy at the University of South Carolina, Columbia, South Carolina, USA.Department of Clinical Pharmacy & Outcomes Sciences, South Carolina College of Pharmacy at the University of South Carolina, Columbia, South Carolina, USA.Department of Internal Medicine, Vidant Medical Center, Greenville, North Carolina, USA Campbell University School of Pharmacy, Buies Creek, North Carolina, USA.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25022580

Citation

Bland, Christopher M., et al. "Musculoskeletal Safety Outcomes of Patients Receiving Daptomycin With HMG-CoA Reductase Inhibitors." Antimicrobial Agents and Chemotherapy, vol. 58, no. 10, 2014, pp. 5726-31.
Bland CM, Bookstaver PB, Lu ZK, et al. Musculoskeletal safety outcomes of patients receiving daptomycin with HMG-CoA reductase inhibitors. Antimicrob Agents Chemother. 2014;58(10):5726-31.
Bland, C. M., Bookstaver, P. B., Lu, Z. K., Dunn, B. L., & Rumley, K. F. (2014). Musculoskeletal safety outcomes of patients receiving daptomycin with HMG-CoA reductase inhibitors. Antimicrobial Agents and Chemotherapy, 58(10), 5726-31. https://doi.org/10.1128/AAC.02910-14
Bland CM, et al. Musculoskeletal Safety Outcomes of Patients Receiving Daptomycin With HMG-CoA Reductase Inhibitors. Antimicrob Agents Chemother. 2014;58(10):5726-31. PubMed PMID: 25022580.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Musculoskeletal safety outcomes of patients receiving daptomycin with HMG-CoA reductase inhibitors. AU - Bland,Christopher M, AU - Bookstaver,P Brandon, AU - Lu,Z Kevin, AU - Dunn,Brianne L, AU - Rumley,Kathey Fulton, AU - ,, Y1 - 2014/07/14/ PY - 2014/7/16/entrez PY - 2014/7/16/pubmed PY - 2015/5/21/medline SP - 5726 EP - 31 JF - Antimicrobial agents and chemotherapy JO - Antimicrob. Agents Chemother. VL - 58 IS - 10 N2 - Daptomycin, a cyclic lipopeptide antibiotic, and 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) are commonly administered in the inpatient setting and are associated with creatine phosphokinase (CPK) elevations, myalgias, and muscle weakness. Safety data for coadministration of daptomycin with statins are limited. To determine the safety of coadministration of daptomycin with statin therapy, a multicenter, retrospective, observational study was performed at 13 institutions in the Southeastern United States. Forty-nine adult patients receiving statins concurrently with daptomycin were compared with 171 patients receiving daptomycin without statin therapy. Detailed information, including treatment indication and duration, infecting pathogen, baseline and subsequent CPK levels, and presence of myalgias or muscle complaints, was collected. Myalgias were noted in 3/49 (6.1%) patients receiving combination therapy compared with 5/171 (2.9%) of patients receiving daptomycin alone (P = 0.38). CPK elevations of >1,000 U/liter occurred in 5/49 (10.2%) patients receiving combination therapy compared to 9/171 (5.3%) patients receiving daptomycin alone (P = 0.32). Two of five patients experiencing CPK elevations of >1,000 U/liter in the combination group had symptoms of myopathy. Three patients (6.1%) discontinued therapy due to CPK elevations with concurrent myalgias in the combination group versus 6 patients (3.5%) in the daptomycin-alone group (P = 0.42). CPK levels and myalgias reversed upon discontinuation of daptomycin therapy. Overall musculoskeletal toxicity was numerically higher in the combination group but this result was not statistically significant. Further prospective study is warranted in a larger population. SN - 1098-6596 UR - https://www.unboundmedicine.com/medline/citation/25022580/Musculoskeletal_safety_outcomes_of_patients_receiving_daptomycin_with_HMG_CoA_reductase_inhibitors_ L2 - http://aac.asm.org/cgi/pmidlookup?view=long&pmid=25022580 DB - PRIME DP - Unbound Medicine ER -