Our case of a pustular eruption associated with the use of daptomycin is unique. In our patient, the clinical and histologic presentation was consistent with the diagnosis of AGEP. Based on the patient’s history of starting daptomycin 4 days prior to the onset of symptoms, we believe that the drug was associated with the development of AGEP. She had not recently undergone any other medication changes, as she had been taking her other medications for at least 3 years with the exception of warfarin and oxycodone hydrochloride, which were initiated 5 weeks prior to the eruption.
Because of its unique mechanism of action as well as the prevalent phenomenon of antibiotic resistance, daptomycin is increasingly used for the treatment of complicated skin and skin structure infections caused by gram-positive organisms. As the use of daptomycin increases, it is important for physicians to be aware of its potential cutaneous complications.