Analysis of a case of pancytopenia complicated with delayed drug fever induced by vancomycin infusion in a child
- VernacularTitle:1例儿童输注万古霉素致全血细胞减少症合并迟发型药物热的病例分析
- Author:
Xiaoxu CHEN
1
;
Feiran WU
2
;
Hongmeng LI
1
;
Ziwei JING
1
;
Hui ZHANG
3
Author Information
1. Dept. of Pharmacy，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，China
2. Dept. of Minimal Invasive Spinal Surgery，Luoyang Orthopedic-Traumatological Hospital of Henan Province，Zhengzhou 450016，China
3. Dept. of Pediatric Surgery，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，China
- Publication Type:Journal Article
- Keywords:
vancomycin;
children;
pancytopenia;
delayed drug fever;
case analysis
- From:
China Pharmacy
2023;34(17):2139-2143
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To accurately identify the rare adverse drug reactions （ADR） of vancomycin-pancytopenia in order to promote its safe use. METHODS Through a case report of a child with suppurative hip arthritis who developed pancytopenia combined with delayed drug fever caused by intravenous infusion of vancomycin，Naranjo score method and related literature were used to summarize the association between the ADR and vancomycin and its possible mechanism， and suggestions for rational use of vancomycin in pediatric patients were put forward. RESULTS & CONCLUSIONS The association of pancytopenia combined with delayed drug fever and vancomycin in this child is “very likely”. In clinical practice， it is difficult to distinguish between pancytopenia combined with delayed drug fever from fever and hematopenia caused by aggravation of infection. Medical staff should increase their awareness of vancomycin rare ADR such as pancytopenia， and pharmacists should assist medical staff in timely screening for ADR. The initial dose of vancomycin infusion for children should start from 60 mg/（kg·d），and the blood concentration should be monitored 48 h after the first infusion and the dose should be adjusted in time to maintain the valley concentration of vancomycin at 5-15 mg/L to prevent the occurrence of ADR caused by excessive blood concentration. For children who have been using vancomycin for more than one week，the blood routine should be rechecked regularly. Once pancytopenia occurs，the drug should be stopped immediately，and symptomatic treatment should be given according to the situation.
