Anaphylactoid reactions to vancomycin during anaesthesia: two clinical reports

Symons, Nigel L. P.; Hobbes, Alick; Leaver, H.

doi:10.1007/bf03010047

Cited by 35 publications

(11 citation statements)

References 11 publications

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“…One serious reaction requiring respirator treatment for 2 days was observed in our study, and a similar case has been reported previously. 26 We believe that a slow vancomycin infusion under close surveillance is safe.…”

Section: '4'6'1~mentioning

confidence: 95%

Results of a randomized trial of vancomycin prophylaxis in craniotomy

Blomstedt¹,

Kyttä²

1988

Journal of Neurosurgery

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A single prophylactic dose of vancomycin was given in 143 supratentorial craniotomies with a bone flap and 26 suboccipital craniotomies. No antimicrobial agents were given to two similar groups of patients: 172 with supratentorial craniotomy and 19 with suboccipital craniotomy. The infection rate in the vancomycin groups was significantly lower (p less than 0.013), and bone-flap infections alone, the most common infection after supratentorial craniotomy, were significantly fewer (p less than 0.042). Antimicrobial prophylaxis is recommended only for selected high-risk groups. Since a bone flap is devascularized, its resistance to infection is reduced and, once infected, it usually requires surgical removal. Patients undergoing craniotomy with a bone flap therefore form a high-risk group, and antimicrobial prophylaxis is justified.

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Section: '4'6'1~mentioning

confidence: 95%

Results of a randomized trial of vancomycin prophylaxis in craniotomy

Blomstedt¹,

Kyttä²

1988

Journal of Neurosurgery

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“…Pretreatment of patients with an antihistamine such as diphenhydramine or hydroxyzine prior to the first dose of vancomycin protects against RMS (16,17). Less common anaphylactoid reactions to vancomycin include oliguria, generalized edema, and non-cardiogenic pulmonary edema (18).…”

Section: Overview Of Vancomycin Pharmacologymentioning

confidence: 99%

Prophylactic Use of Vancomycin in Adult Cardiology and Cardiac Surgery

Movahed

Kasravi

Bryan

2004

J Cardiovasc Pharmacol Ther

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The recent appearance of S. aureus and S. epidermidis strains with reduced susceptibility to vancomycin and the spread of vancomycin-resistant enterococci raise the specter of endovascular infections that will be difficult or impossible to cure with available drugs. We review issues concerning prophylactic use of vancomycin in adult cardiology and cardiac surgery with special attention to dosing and indications. There is no indication for routine use of prophylactic vancomycin in pacemaker implantations, cardiac catheterization, and transesophageal echocardiography. In institutions with high incidence of MRSA and MRSE, vancomycin may be used for antibiotic prophylaxis in place of cephalosporins for pacemaker or defibrillator implantation. Strongest evidence in support of prophylactic use of vancomycin is during cardiac surgeries particularly valvular surgeries in institutions with high prevelance of MRSA and MRSE. When vancomycin is used prior to open heart surgery, the dose should be 15 mg/kg rather than a standard 1 g dose often recommended in the literature and used by 85% of institutional pharmacists who responded to our survey. Cardiologists and cardiac surgeons should assume leadership roles in promoting its responsible use. Condensed abstractThe emergence of vancomycin-resistant bacteria should concern cardiologists and cardiac surgeons because of the potential for untreatable endovascular infections. We review current guidelines and controversies concerning the appropriate use of this agent.

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“…In the case reported by Fisher 25 hypotension was due to hypovolemia. Symons et al 26 reported two cases of anaphylactoid reactions to vancomycin with an increase in systemic and pulmonary capillary pemleability. In the report by Silvemran et al 27 of an anaphylactic reaction to penicillin, there was a decrease in arterial pressure, cardiac output, and capillary pulmonary wedge pressure, and an increase in peak airway pressure, pulmonary vascular resistance and systemic vascular resistance.…”

Section: Time Rainmentioning

confidence: 99%

“…32 In man, respiratory disturbances seen during anaphylactoid and/or anaphylactic reactions are primarily bronehospasm, and less frequently pulmonary oedema. [25][26][27][28] In the monkey, Revenas et al ~3 showed that during antigen-induced anaphylaxis dynamic compliance was decreased as a result of constriction of small airways and pulmonary congestion. In the present study, the injection of cremophor EL resulted in a significant and persistent decrease in dynamic thoracopulmonary compliance.…”

Section: Time Rainmentioning

confidence: 99%

The effects of cremophor EL in the anaesthetized dog

et al. 1987

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The effects of cremophor EL in the anaesthetized dogThe effects of cremophor EL were studied in 13 in PCWP, per cent at the end of infusion, -32 per cent 150 minutes after the end of infusion). Heart rate and systemic vascular resistance did not vary significantly. Pulmonary vascular resistance increased at the end of infusion, five and ten minutes after the end of infusion (+ 734, +548 and +439 per cent respectively). Plasma volume decreased I0 and 30 minutes after the end of infusion (-28 and -30.5 per cent respectively). per cent at the end of iofusion). Platelet and white cell counts decreased markedly. There was a marked and sustained increase in plasma hista-

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Anaphylactoid reactions to vancomycin during anaesthesia: two clinical reports

Abstract: Vancomycin is becoming increasingly used for pro

Cited by 35 publications

References 11 publications

Results of a randomized trial of vancomycin prophylaxis in craniotomy

Results of a randomized trial of vancomycin prophylaxis in craniotomy

Prophylactic Use of Vancomycin in Adult Cardiology and Cardiac Surgery

The effects of cremophor EL in the anaesthetized dog

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