High alanine aminotransaminase associated with daptomycin use in a premature infant

Daptomycin is a cyclic lipopeptide antibiotic, a fermented product derived from Streptomyces roseosporus that is active against gram-positive bacteria. We report on a premature infant who developed hepatotoxicity as an adverse drug reaction after the administration of daptomycin 6 mg per kg per dose every 12 h. The patient had an unexpectedly sharp rise of alanine aminotransaminase, prothrombin time and international normalised ratio on the second day following daptomycin administration. This case illustrates a previously unrecognised adverse drug effect associated with daptomycin use in infants.