A Case of Increased Creatin Kinase Level Caused by Daptomycin

Daptomycin is a fermentation product produced by Streptomyces roseosporus, which can act on aerobic and anaerobic gram-positive bacteria in its cyclic form. Daptomycin has activity against methicillin-resistant Staphylococcus aureus (MRSA), glycopeptide-intermediate Staphylococcus aureus, coagulase-negative staphylococcus species, penicillin-resistant Streptococcus pneumoniae, enterococci, vancomycin-resistant bacteria such as Pediococcus, Leuconostoc and Lactobacillus, gram positive anaerobic bacteria including Clostridium difficile, Corynebacterium and Bacillus bacteria and peptostreptococci. The primary toxicity associated with daptomycin is myopathy, which is rare. Muscle pain, muscle weakness and increased creatine kinase (CK) levels (MM isoenzyme) are detected due to myopathy. Paresthesia and reversible paralysis can be observed infrequently. In this article, a case of daptomycin-associated creatine phosphokinase elevation is presented. Clinical signs and symptoms improved with normal CK levels after discontinuation of daptomycin. Myopathy should be kept in mind in case of sudden muscle pain and high CK levels during the treatment with daptomycin.

Daptomisin Kullanýmýna Baðlý Geliþen Kreatin Kinaz Yüksekliði Olgusu

Daptomisin Streptomyces roseospours fermantasyon yan ürünü olarak elde edilen, siklik yapýda aerop ve anaerop gram pozitif bakterilere etki edebilen geniþ spektrumlu bir antibiyotiktir. Metisiline dirençli Staphylococcus aureus (MRSA), glikopeptid antibiyotiklere azalmýþ duyarlýlýk gösteren (intermediate) staphylococcus aureus, koagülaz negatif stafilokok türleri, penisiline dirençli Streptococcus pneumoniae, enterokoklar, Pediococus, Leuconostoc ve Lactobacillus gibi vankomisine dirençli bakterilere, Clostridium difficile dahil gram pozitif anaerob bakterilere, Corynebacterium ve Bacilluscinsi bakterilere, peptostreptokoklara karþý etkin olduðu bildirilmiþtir. Daptomisin kullanýmýna baðlý geliþen primer toksisite myopatidir. Nadir görülür. Myopatiye baðlý kas aðrýsý, kas güçsüzlüðü ve kreatin kinaz (CPK) enziminde (MM izoenzimi) artýþ saptanýr. Parestezi ve geri dönüþümlü olarak paralizi seyrek de olsa görülebilir. Bu yazýda daptomisin iliþkili kreatin fosfokinaz (CK) yüksekliði geliþen bir olgu sunulmuþtur. Ýlacýn kesilmesi ve destek tedavi ile klinik kontrol altýna alýnmýþ ve takiplerde CK normale gelmiþtir. Daptomisin kullanýmý esnasýnda ani geliþen kas aðrýsý ve CK yüksekliði durumunda miyopati yan etkisi akýlda tutulmalýdýr.