Clarithromycin-induced rhabdomyolysis: a case report

Abstract

Rhabdomyolysis is a clinical and laboratory syndrome that is caused by various etiologies, involving the skeletal muscle. Clarithromycin, like other macrolides, is an inhibitor of CYP450 3A4, the major enzyme responsible for the metabolism of several drugs, in particular some statins. Rhabdomyolysis related to macrolide-statin interaction has previously been described. To date, rhabdomyolysis induced by clarithromycin has been described in only one previous report. We describe the case of a 90-year-old Caucasian male, admitted to the University Hospital of Pisa for dyspnea, who developed rhabdomyolysis associated with clarithromycin administration.

Keywords: clarithromycin; pneumonia; rhabdomyolysis.

Figure 1

Patient blood creatine kinase (CK) and myoglobin levels from emergency room (ER) to recovery from rhabdomyolysis. Notes: The first four points of blood myoglobin level were obtained as part of two cardiac marker curves, while the following for rhabdomyolysis monitoring. The basal two points of blood CK value were obtained as routine analysis at ER and on the first day of hospitalization. The following CK values were measured for rhabdomyolysis monitoring after the unexpected myoglobin increase (see text for detail). Dotted part of the CK line represents the lacking CK values.