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Malignant OE Treatment Duration — SCE Infectious Diseases MCQ

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HardRespiratory InfectionMalignant OE Treatment DurationSCE Infectious Diseases

A patient receiving daptomycin for VRE endocarditis develops new symmetrical proximal muscle pain. CPK is 7 times ULN and there is no alternative explanation. What should be done now?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Discontinue daptomycin and investigate and monitor the myopathy

Explanation lettering: C = shown as A · D = shown as B · A = shown as C · B = shown as D

A is correct. The SmPC advises discontinuing daptomycin when otherwise unexplained muscle symptoms accompany CPK above five times ULN. This patient has crossed that symptomatic threshold. A higher laboratory-only threshold is not a licence to continue symptomatic toxicity, merely reducing the dose is unsupported, and withdrawing another myotoxic medicine does not remove the need to stop daptomycin. Renal function, urine, electrolytes and alternative antimicrobial cover should be reviewed while CPK and symptoms resolve.

Reference: Cubicin 500 mg SmPC: https://www.medicines.org.uk/emc/product/8124/smpc