Allergy Asthma Immunol Res.  2011 Jul;3(3):194-198. 10.4168/aair.2011.3.3.194.

Vancomycin-Associated Spontaneous Cutaneous Adverse Drug Reactions

• An SY
• Hwang EK
• Kim JH
• Kim JE
• Jin HJ
• Jin SM
• Kyun JO
• Lee YH
• Park HS
• Choi YW
• Lim SK
• Ye YM

• KMID: 1803325
• DOI: http://doi.org/10.4168/aair.2011.3.3.194

Abstract

PURPOSE
With the increase in vancomycin use, adverse drug reactions (ADRs) associated with vancomycin have been reported increasingly more often. However, the characteristics of cutaneous ADRs with and without systemic reactions (SRs) have not been described. This study investigated the characteristics of spontaneously reported and assessed ADRs associated with vancomycin by a pharmacovigilance center.
METHODS
ADRs (n=121) associated with vancomycin in 96 patients were collected from 2008 to 2009. Records from physician- and nurse-reported suspected cases of vancomycin ADRs, ADR type, latent period, and laboratory results were compared between cutaneous ADRs with and without SRs.
RESULTS
The main vancomycin-related ADRs were skin rashes (47.9%), hematologic abnormalities (17.36%), fever (12.4%), and elevated serum creatinine (12.4%). Significant differences were observed in latent period (days) and the mean change in eosinophils (%) between cutaneous (9.21+/-9.71 and 1.4+/-3.4, respectively) and other ADRs (14.03+/-11.71 and -0.5+/-3.5, respectively). Twelve cases of cutaneous ADRs with SRs had been initially reported as cutaneous ADRs only. Mean changes in the eosinophil count were significantly higher for cutaneous ADRs with SRs compared to those without SRs.
CONCLUSIONS
Skin rashes accompanied by peripheral eosinophilia, representing suspected immune-mediated delayed hypersensitivity reactions, are a common vancomycin ADR. For the early and exact detection of ADRs associated with vancomycin administration, close monitoring of laboratory tests, including complete blood counts with differential analysis, is recommended.

Keyword

Vancomycin; adverse drug reaction; eosinophilia

MeSH Terms

Blood Cell Count
Creatinine
Drug Toxicity
Eosinophilia
Eosinophils
Exanthema
Fever
Humans
Hypersensitivity, Delayed
Pharmacovigilance
Vancomycin
Creatinine
Vancomycin

Figure

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  Figure Classification of 121 spontaneous ADRs associated with vancomycin administration.

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