Patient-Centered Focused Review| Volume 365, ISSUE 5, P450-456, May 2023

Download started.


Daptomycin-induced rhabdomyolysis complicated with acute gouty arthritis

Published:January 21, 2023DOI:


      Rhabdomyolysis is a well-documented side effect of daptomycin and is associated with hyperuricemia. However, the occurrence of acute gouty arthritis secondary to rhabdomyolysis-induced hyperuricemia has not been reported. We report a case of a patient who presented with daptomycin-induced rhabdomyolysis prior to the usual 7-10-day administration period. This case was complicated with acute gouty arthritis after 7 days from the onset of rhabdomyolysis symptoms. Treatment consisted of fluid management with the addition of prednisone for gouty arthritis treatment given his poor kidney function. This report indicates the importance of early monitoring of creatine kinase levels in patients on daptomycin to prevent complications from rhabdomyolysis.

      Key Indexing Terms

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of the Medical Sciences
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Heidary M
        • Khosravi AD
        • Khoshnood S
        • et al.
        J Antimicrob Chemother. 2018; 73: 1-11
        • Frankenfeld C
        • Mittal S
        • Melendez Y
        • et al.
        Daptomycin: a comparison of two intravenous formulations.
        Drug Des Devel Ther. 2018; 12: 1953-1958
        • Vlashyn OO
        • Lorenz AM
        • Sobhanie MM
        • et al.
        Safety outcomes with high-dose daptomycin in patients with acute kidney injury and/or end-stage renal disease.
        J Clin Pharm Ther. 2021; 46: 363-368
        • Humphries RM
        • Pollett S
        • Sakoulas G.
        A current perspective on daptomycin for the clinical microbiologist.
        Clin Microbiol Rev. 2013; 26: 759-780
        • Stewart PS
        • Davison WM
        • Steenbergen JN.
        Daptomycin rapidly penetrates a Staphylococcus epidermidis biofilm.
        Antimicrob Agents Chemother. 2009; 53: 3505-3507
        • Cabral BMI
        • Edding SN
        • Portocarrero JP
        • et al.
        Dis Mon. 2020; 66101015
        • Bosch X
        • Poch E
        • Grau JM.
        Rhabdomyolysis and acute kidney injury.
        N Engl J Med. 2009; 361: 62-72
        • Khan FY.
        Rhabdomyolysis: a review of the literature.
        Neth J Med. 2009; 67: 272-283
        • Teng C
        • Baus C
        • Wilson JP
        • et al.
        Rhabdomyolysis associations with antibiotics: a pharmacovigilance study of the FDA adverse event reporting system (FAERS).
        Int J Med Sci. 2019; 16: 1504-1509
        • Margolin L.
        Impaired rehabilitation secondary to muscle weakness induced by meropenem.
        Clin Drug Investig. 2004; 24: 61-62
        • Lew J
        • Fitzhugh CD
        • Tisdale JF
        • et al.
        Increased Rates of rhabdomyolysis in male hematopoietic cell transplantation recipients taking sirolimus and trimethoprim/sulfamethoxazole.
        Transplant Cell Ther. 2021; 27 (1019.e1011-1019.e1014)
        • Dare RK
        • Tewell C
        • Harris B
        • et al.
        Effect of statin coadministration on the risk of daptomycin-associated myopathy.
        Clin Infect Dis. 2018; 67: 1356-1363
        • Ibarra G
        • Elmaaz A
        • Hennel D
        • et al.
        Daptomycin-induced hyperkalemia as an early sign of rhabdomyolysis in a diabetic patient.
        Cureus. 2020; 12: e11674
        • Patel SJ
        • Samo TC
        • Suki WN.
        Early-onset rhabdomyolysis related to daptomycin use.
        Int J Antimicro Agents. 2007; 30: 472-474
        • Giannoglou GD
        • Chatzizisis YS
        • Misirli G.
        The syndrome of rhabdomyolysis: pathophysiology and diagnosis.
        Eur J Intern Med. 2007; 18: 90-100
        • Stahl K
        • Rastelli E
        • Schoser B.
        A systematic review on the definition of rhabdomyolysis.
        J Neurol. 2020; 267: 877-882
        • Gupta A
        • Thorson P
        • Penmatsa KR
        • et al.
        Rhabdomyolysis: revisited.
        Ulster Med J. 2021; 90: 61-69
        • Michelsen J
        • Cordtz J
        • Liboriussen L
        • et al.
        Prevention of rhabdomyolysis-induced acute kidney injury - A DASAIM/DSIT clinical practice guideline.
        Acta Anaesthesiol Scand. 2019; 63: 576-586
        • Dalbeth N
        • Merriman TR
        • Gout Stamp LK.
        Lancet. 2016; 388: 2039-2052
        • Ernst ME
        • Fravel MA.
        Febuxostat: a selective xanthine-oxidase/xanthine-dehydrogenase inhibitor for the management of hyperuricemia in adults with gout.
        Clin Ther. 2009; 31: 2503-2518
        • Patel SJ
        • Samo TC
        • Suki WN.
        Early-onset rhabdomyolysis related to daptomycin use.
        Int J Antimicrob Agents. 2007; 30: 472-474
        • Ng JK
        • Schulz LT
        • Rose WE
        • et al.
        Daptomycin dosing based on ideal body weight versus actual body weight: comparison of clinical outcomes.
        Antimicrob Agents and Chemother. 2014; 58: 88-93
        • Fox AN
        • Smith WJ
        • Kupiec KE
        • et al.
        Daptomycin dosing in obese patients: analysis of the use of adjusted body weight versus actual body weight.
        Ther Adv Infect Dis. 2019; 62049936118820230