The study of vancomycin use and its adverse reactions associated to patients of a brazilian university hospital

Abstract

BackgroundVancomycin is an antibiotic of growing importance in the treatment of hospital infections, with particular emphasis on its value in the fight against methicillin-resistant Staphylococcus aureus. However its usage profile must be evaluated to assure maximum benefit and minimum risk.FindingsA cross-sectional retrospective study was carried out among inpatients that received vancomycin in a Brazilian quaternary hospital. The occurrence of adverse reactions reported was evaluated in medical records relating to patients taking vancomycin during a one year period. Males comprised 52% (95% CI: 41.7-60.2%) of the sample population, with a mean age of 50.6 (95% CI: 47.2-54.0) years and mean treatment period of 9.7 (95% CI: 8.0-11.5) Days. It was verified that nephrotoxicity occurred in 18.4% (95% CI: 11.3-27.5) of patients, Red man syndrome occurred in 2% (95% CI 0.2-7.2), while the occurrence of thrombocytopenia was 7.1% (95% CI: 2.9-14.2).ConclusionsIt may be noted that even after 50 years of use, adverse reactions associated with vancomycin continue with high frequency, presenting a public health problem, especially considering its current use in cases of multidrug resistant infections. In this context, we emphasize the importance of intensive pharmacovigilance in hospital as a surveillance tool after drug approval by the sanitary authority.

Steady-state Pharmacokinetics of Vancomycin in Children Admitted to Pediatric Intensive Care Unit of a Tertiary Referral Center

“…To our knowledge, this is the first Indian study carried out to assess the steady-state pharmacokinetics of vancomycin in critically ill pediatric subjects. It is well known that short duration of vancomycin infusion is strongly associated with ADRs such as red man syndrome; 8,18,19 in the present study, all subjects received vancomycin infusion for the duration of 1 hour and it was well tolerated. However, one subject with hepatic dysfunction was discontinued from vancomycin and shifted to linezolid due to raised creatinine.…”

Vancomycin‐induced thrombocytopenia: a rare adverse effect in a patient ­submitted to bone graft in the jaw

“…By analyzing 350 medical records of patients that had made use vancomycin, and after excluding those whose laboratorial data were insufficient, adverse effects were found in 30 cases. Among these, thrombocytopenia was found in seven cases (2% of all patients treated with vancomycin), a surprising finding since such a response is considered historically rare …”

“…Vancomycin was developed in 1956 and until around 1970, it was widely used for the treatment of different infections caused by Gram‐positive microorganisms and in patients allergic to penicillin. In the 1980s, with the rapid expansion of antibiotic‐resistant bacteria, it returned to the market where it remains until now for the treatment of methicillin‐resistant Staphylococcus aureus (MRSA) and penicillin‐resistant Streptococcus , the most serious types of infections . Among the antimicrobials of choice for the treatment of serious infections by MRSA are linezolid, vancomycin, tigecycline, daptomycin, and ceftaroline …”

Single-dose and Steady-state Pharmacokinetics of Vancomycin in Critically Ill Patients Admitted to Medical Intensive Care Unit of India

“…The recommended dose (1 g every 12 hours) infused over 1 hour was well-tolerated by all subjects compared to the short duration of vancomycin which is known to be associated with many AEs. 10,20…”