Department of Pharmacy, UPMC Shadyside, Pittsburgh, PA, USA.
Division of Infectious Diseases, UPMC Shadyside, Pittsburgh, PA, USA.
J Clin Pharm Ther. 2019 Dec;44(6):966-969. doi: 10.1111/jcpt.13010. Epub 2019 Aug 13.
The combination of HMG-CoA reductase inhibitors (statins) and fluoroquinolones generally is not considered a significant risk factor for rhabdomyolysis. Rhabdomyolysis is a known risk associated with statin therapy but has seldom been described with fluoroquinolone use. We describe a case of acute rhabdomyolysis involving the co-administration of atorvastatin and levofloxacin.
A 65-year-old white male presented with clinical and laboratory evidence of rhabdomyolysis after approximately 19 days of levofloxacin therapy for treatment of a prosthetic joint infection. His symptoms resolved after discontinuation of levofloxacin and atorvastatin therapy and did not recur following reintroduction of atorvastatin therapy.
Delayed-onset rhabdomyolysis may occur in patients receiving levofloxacin. Weekly complete metabolic panels along with patient education about symptoms of rhabdomyolysis should be considered, particularly in patients on concurrent medications known to cause rhabdomyolysis.
通常认为 HMG-CoA 还原酶抑制剂(他汀类药物)与氟喹诺酮类药物联合使用不是横纹肌溶解的重要危险因素。横纹肌溶解是他汀类药物治疗的已知风险,但很少有氟喹诺酮类药物使用相关的描述。我们描述了一例阿托伐他汀和左氧氟沙星联合使用导致急性横纹肌溶解的病例。
一名 65 岁白人男性,在接受左氧氟沙星治疗约 19 天后出现了横纹肌溶解的临床和实验室证据,用于治疗人工关节感染。停用左氧氟沙星和阿托伐他汀治疗后,他的症状得到缓解,且在重新开始使用阿托伐他汀治疗后没有复发。
接受左氧氟沙星治疗的患者可能会发生迟发性横纹肌溶解。应考虑每周进行全面代谢检查,并对横纹肌溶解的症状进行患者教育,特别是在同时使用已知会引起横纹肌溶解的药物的患者中。