Daptomycin is a lipopeptide antibiotic effective against MRSA and VRE. Why is it contraindicated for the treatment of pneumonia?
- A It causes severe pulmonary fibrosis
- B It cannot penetrate the blood-brain barrier
- C It is inactivated by pulmonary surfactant ✓
- D It induces bronchospasm via histamine release
Correct answer: C. It is inactivated by pulmonary surfactant
Explanation
Daptomycin binds to the bacterial cell membrane causing depolarization and cell death. It is inactivated by pulmonary surfactant, which binds the drug, rendering it ineffective for pneumonia. It is used for skin and soft tissue infections, bacteremia, and endocarditis. Nephrotoxicity is associated with vancomycin, not daptomycin. Rhabdomyolysis is the main concern with daptomycin, requiring monitoring of creatine phosphokinase levels.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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