Daptomycin Monitoring — SCE Infectious Diseases MCQ

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EasyAntimicrobial StewardshipDaptomycin MonitoringSCE Infectious Diseases

A 50-year-old man is referred to the OPAT service for a 6-week course of IV Daptomycin for MRSA osteomyelitis. What specific monitoring is required during Daptomycin therapy?

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Correct answer: E — Weekly CPK (creatine phosphokinase) — Daptomycin causes myopathy/rhabdomyolysis

Daptomycin causes dose-dependent skeletal muscle toxicity (myopathy, rhabdomyolysis) mediated by its interaction with myocyte membranes. CPK should be monitored weekly during therapy and the drug discontinued if CPK rises >5× ULN or if symptoms of myopathy develop. Concomitant statins should ideally be held during Daptomycin therapy as they independently increase myopathy risk. Daptomycin TDM is not routinely performed. Eosinophilic pneumonia is a rare but important adverse effect — Daptomycin is inactivated by surfactant and must never be used for pneumonia.

Reference: BNF 2024 – Daptomycin; BSAC 2023 – OPAT monitoring