Korean J Intern Med.
2020 May;35(3):714-722. 10.3904/kjim.2018.404.
Incidence of teicoplanin adverse drug reactions among patients with vancomycin-associated adverse drug reactions and its risk factors
- Affiliations
-
- 1Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
- 2Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- 3Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- 4Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
- 5Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, Korea
- 6Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
- KMID: 2502062
- DOI: http://doi.org/10.3904/kjim.2018.404
Abstract
- Background/Aims
Teicoplanin can be used as an alternative to vancomycin when treating beta-lactam-resistant gram-positive bacterial infections. Both vancomycin and teicoplanin are associated with relatively high rates of adverse drug reactions (ADRs), including hypersensitivity reactions. There is limited data on teicoplanin-vancomycin cross-reactivity. This study examined the incidence of teicoplanin ADRs and risk factors for cross-reactivity between vancomycin and teicoplanin.
Methods
We analyzed the incidence of teicoplanin ADRs in a retrospective study of 304 newly teicoplanin-exposed, immunocompetent, hospitalized patients at a single Korean Medical Center between January 1, 2006 and December 31, 2015.
Results
Among 304 patients, 238 (78.3%) experienced vancomycin-associated ADRs prior to their teicoplanin exposure and 58 (19.1%) experienced teicoplanin- associated ADRs, which were mostly hypersensitivity reactions without acute kidney injury. The incidence of teicoplanin ADRs was higher in patients who previously experienced vancomycin-related ADRs (23.1% vs. 5.3%, p < 0.001). History of drug allergy was a statistically significant risk factor of teicoplanin ADRs. The incidence of teicoplanin ADRs significantly increased in patients with multiple organ involvement in vancomycin hypersensitivity reactions.
Conclusions
Teicoplanin should be administered with caution and clinicians must consider the risk factors of cross-reaction when prescribing teicoplanin to individuals with a history of vancomycin hypersensitivity.
