title: Daptomycin-induced eosinophilic pneumonia - a systematic review.
abstract: OBJECTIVE
  Eosinophilic pneumonia comprises a group of lung diseases in which eosinophils appear in increased numbers in the lungs and sometimes in the bloodstream. Several case reports link daptomycin use to this phenomenon.
  
  
  CONCLUSIONS
  We performed a systematic literature review to identify cases of eosinophilic pneumonia associated with daptomycin use. Relevant studies were identified by searching Pubmed/Medline, EMBASE, Google Scholar, Cochrane Database of Systematic Reviews, and Clin-Alert from inception to May 2016, and manual searches of reference lists. All case reports that include information regarding patient age, indication, clinical and objective findings, treatment and outcome were evaluated. Abstracts from conference proceedings as well as case reports not in English were excluded. Descriptive statistics were used to analyze the data. Thirty-five patient-cases were included in the final analysis. Patients most likely to be identified with daptomycin-induced eosinophilic pneumonia were male (83%) and elderly (mean age 65.4 ± 15 years). The dose for daptomycin ranged from 4 to 10 mg/kg/day, but included a large number of patients with renal dysfunction. The average duration of daptomycin therapy upon onset of EP symptoms was 2.8 ± 1.6 weeks. Majority of patients presented with dyspnea (94%), fever (57%) and were also found to have peripheral eosinophilia (77%) and infiltrates/opacities of CT/CXR (86%). Symptom improvement was seen after daptomycin discontinuation (24 h to 1 week). The majority of patients were also prescribed treatment with corticosteroids (66%).
  
  
  CONCLUSIONS
  Clinicians should be aware of daptomycin-induced eosinophilic pneumonia and its symptoms along with its presentation and treatment.
authors.affiliation: Providence Veterans Affairs Medical Center, Providence, RI USA.
authors.forename: Priyasha
authors.initials: P
authors.lastname: Uppal
authors.affiliation: Providence Veterans Affairs Medical Center, Providence, RI USA ; Department of Pharmacy Practice, University of Rhode Island, 7 Greenhouse Rd, Suite 295 J, Kingston, RI 02881 USA ; Warren Alpert Medical School of Brown University, Providence, RI USA.
authors.forename: Kerry L
authors.initials: KL
authors.lastname: LaPlante
authors.affiliation: Providence Veterans Affairs Medical Center, Providence, RI USA ; Warren Alpert Medical School of Brown University, Providence, RI USA.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Gaitanis
authors.affiliation: Providence Veterans Affairs Medical Center, Providence, RI USA ; Warren Alpert Medical School of Brown University, Providence, RI USA.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Jankowich
authors.affiliation: Department of Pharmacy Practice, University of Rhode Island, 7 Greenhouse Rd, Suite 295 J, Kingston, RI 02881 USA.
authors.forename: Kristina E
authors.initials: KE
authors.lastname: Ward
keywords: Daptomycin; Eosinophilia; Pneumonia