Uppal Priyasha, LaPlante Kerry L, Gaitanis Melissa M, Jankowich Matthew D, Ward Kristina E
Providence Veterans Affairs Medical Center, Providence, RI USA.
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.
Antimicrob Resist Infect Control. 2016 Dec 12;5:55. doi: 10.1186/s13756-016-0158-8. eCollection 2016.
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.
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%).
Clinicians should be aware of daptomycin-induced eosinophilic pneumonia and its symptoms along with its presentation and treatment.
嗜酸性粒细胞性肺炎是一组肺部疾病，其中嗜酸性粒细胞在肺部数量增多，有时也会出现在血液中。有几例病例报告将达托霉素的使用与这种现象联系起来。
我们进行了一项系统的文献综述，以确定与使用达托霉素相关的嗜酸性粒细胞性肺炎病例。通过检索PubMed/Medline、EMBASE、谷歌学术、Cochrane系统评价数据库和Clin-Alert（从创建到2016年5月）以及手动检索参考文献列表来识别相关研究。对所有包含患者年龄、适应症、临床和客观检查结果、治疗及转归信息的病例报告进行评估。会议论文摘要以及非英文的病例报告被排除。采用描述性统计分析数据。最终分析纳入了35例患者病例。最有可能被诊断为达托霉素诱导的嗜酸性粒细胞性肺炎的患者为男性（83%）且年龄较大（平均年龄65.4±15岁）。达托霉素的剂量范围为4至10mg/kg/天，但包括大量肾功能不全的患者。出现嗜酸性粒细胞性肺炎（EP）症状时，达托霉素治疗的平均持续时间为2.8±1.6周。大多数患者表现为呼吸困难（94%）、发热（57%），还发现外周血嗜酸性粒细胞增多（77%）以及CT/CXR显示浸润/实变（86%）。停用达托霉素后（24小时至1周）症状有所改善。大多数患者还接受了糖皮质激素治疗（66%）。
临床医生应了解达托霉素诱导的嗜酸性粒细胞性肺炎及其症状、表现和治疗方法。
