Uncommon vancomycin: induced side effects

Abstract

Vancomycin has been used with increased frequency during the past 15 years and the most common toxicity with this drug is the red man syndrome . Other adverse effects include neutropenia, fever, phlebitis, nephrotoxicity, ototoxicity, thrombocytopenia, interstitial nephritis, lacrimation, linear IgA bullous dermatosis, necrotizing cutaneous vasculitis and toxic epidermal necrolysis. Only two cases of vancomycin-induced Stevens-Johnson syndrome and one case of pancytopenia have been reported in the medical literature. The treatment for both situations is based on cessation of the vancomycin therapy; in cases of Stevens-Johnson syndrome, antihistamine and/or steroid agents can be used. This article reports a case of pancytopenia and a case of erythema major associated with neutropenia.

A Newborn with Vancomycin-Induced Thrombocytopenia

“…Recently, Bay et al [7] described a child treated with vancomycin for pneumonia caused by S. aureus who developed vancomycin-induced thrombocytopenia. On the other hand, Rocha et al [8] suggested that linezolid and streptogramins might be alternatives whenever vancomycin was the treatment of choice if the patient presented serious adverse events. However, Kohno et al [9] observed that hematological adverse events were more frequent with linezolid, although reversible.…”

Case report of vancomycin-induced pancytopenia

“…The possible mechanisms include marrow suppression, sequestration, and peripheral destruction. Some authors argue against bone marrow suppression owing to bone marrow biopsy findings, which have shown both hypoplasia and hyperplasia of the granulocyte series (5) . However, evidence that supports an immunological etiology also exists.…”

Vancomycin as a risk factor for anaphylactoid reaction (Red Man Syndrome): Literature review

“…For this, the present clinical guide recommends maintaining the minimal concentration (Cmin), determined at the end of administration interval, at a therapeutic range of 5 and 10 µg/ml, and maximum concentration (Cmax), determined 3 h after intravenous administration, at not more than 40 µg/ml. Apart from RMS, other principal adverse reactions of vancomycin include ototoxicity, nephrotoxicity, and phlebitis (Rocha et al, 2002).…”