From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
The seizure-like movements in this 88-year-old patient recovering from agranulocytosis and retropharyngeal abscess while on daptomycin and piperacillin-tazobactam are concerning and require immediate evaluation, with a focus on potential neurotoxicity from daptomycin 1. The patient's advanced age and possible renal impairment increase susceptibility to antibiotic neurotoxicity. Key considerations include:
- Temporarily holding daptomycin to assess its potential role in the seizure-like movements
- Obtaining urgent neurology consultation to evaluate the patient's condition
- Checking drug levels, renal function, electrolytes (especially calcium, magnesium, and potassium), and performing an EEG to rule out seizure activity
- Considering switching to alternative antibiotics based on culture sensitivities, such as linezolid or vancomycin in place of daptomycin, as suggested by studies on antibiotic efficacy and safety 2, 3
- Ensuring adequate hydration and monitoring creatine kinase levels to assess for daptomycin-induced myopathy The most recent and highest quality study on piperacillin/tazobactam, published in 2017, supports its use as an effective treatment for complicated skin and soft tissue infections 2. However, the primary concern in this case is the potential neurotoxicity of daptomycin, and the patient's treatment should be adjusted accordingly to prioritize their safety and minimize adverse effects.