title: Daptomycin-induced eosinophilic pneumonia treated with intravenous corticosteroids.
abstract: OBJECTIVE
  To describe 2 cases of drug-induced eosinophilic pneumonia in patients with variable exposure to daptomycin.
  
  
  METHODS
  In our first case, a 77-year-old male was transferred to our facility for hypoxic respiratory failure, which occurred 1 day after completing a course of daptomycin. There was high clinical suspicion for daptomycin-induced eosinophilic pneumonia, thus the patient was started on intravenous methylprednisolone 40 mg every 6 hours. Within 72 hours, he was liberated from mechanical ventilation, as he experienced dramatic clinical improvement in regard to his oxygenation and radiographs. Approximately 6 weeks after case 1, a second case of eosinophilic pneumonia related to daptomycin was diagnosed. This case occurred in a 74-year-old female who developed respiratory failure requiring noninvasive positive pressure ventilation 72 hours after initiation of a second course of daptomycin. She was treated with methylprednisolone 60 mg every 6 hours and avoided the need for endotracheal intubation and mechanical ventilation.
  
  
  CONCLUSIONS
  Since this potentially life-threatening adverse effect of daptomycin appears more common than previously reported, clinicians should have a high level of suspicion in any patient with recent daptomycin exposure who presents with pulmonary symptoms. In many cases, this process is highly responsive to prompt initiation of corticosteroid therapy.
authors: Department of Pharmacy, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA shao-yuchiu@texashealth.org.
authors: Shao-Yu
authors: SY
authors: Chiu
authors: Department of Pharmacy, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.
authors: Andrew C
authors: AC
authors: Faust
authors: Department of Medicine/Pulmonary Disease, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.
authors: Hemant M
authors: HM
authors: Dand
mesh_terms: D061605:Administration, Intravenous; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D017576:Daptomycin / Q000009:adverse effects*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000627:therapeutic use*; D011657:Pulmonary Eosinophilia / Q000139:chemically induced* / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D017576:Daptomycin; D008775:Methylprednisolone
keywords: critical care; infectious disease; pulmonology