Analysis of hypersensitivity reactions associated with vancomycin or norvancomycin in the treatment of intracranial infection
10.13699/j.cnki.1001-6821.2018.10.029
- VernacularTitle:颅内感染治疗中(去甲)万古霉素相关非速发型过敏反应分析
- Author:
Shi-Qi ZHENG
1
;
Shi-Cai CHEN
;
Gui-Hong ZHAO
;
Xian-Jun LIU
;
Ling-Ling ZHENG
;
He-Li ZHANG
;
Hong-Bing ZHANG
Author Information
1. 首都医科大学附属北京潞河医院神经外科
- Keywords:
vancomycin;
norvancomycin;
drug hypersensitivity;
drug eruptions;
meningitis
- From:
The Chinese Journal of Clinical Pharmacology
2018;34(10):1240-1242
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical characteristics of hypersensitivity reactions associated with vancomycin or norvancomycin in patients with intracranial infection.Methods Medical records of hospitalized patients using vancomycin or norvancomycin were reviewed in the department of neurosurgery of Beijing Luhe hospital,Capital Medical University from September 2013 to September 2017.The clinical manifestations,management and outcome of those cases with hypersensitivity reactions were analyzed.Results Among the 34 patients,12 patients (35.3％) appeared hypersensitivity reactions associated with vancomycin or norvancomycin.6 were men,6 were women,mean age was 64 (32-80) years old,mean weight was 70 (45-85) kg.1 case was confirmed to be associated with vancomycin,another with norvancomycin,10 cases were suspected to be connected with either of the two drugs.Mean incubation period were 22 (11-26) d.They presented maculopapular rash (n =12 cases),itching (n =11 cases),fever (n =9 cases),chills (n =9 cases),the increased proportion of eosinophils (n =7 cases),leucopenia (n =5 cases),liver function damage (n =2 cases).Two cases developed severe drug eruptions.After withdrawl of the culprit drug in time,administrated glucocorticoid (n =6 cases)and gamma globulinn (n =2 cases,severe drug eruptions),10 cases were cured,2 cases were given up by their relatives.Conclusion To optimize the outcome of vancomycin or norvancomycin administration in the treatment of intracranial infection,early adequate dose and adjusting according to the drug serum concentration are preferable.To ensure a safe and effective use of the drug,the culprit drugs should be withdrawn timely and appropriate treatments should be given accordingly,once drug hypersensitive reactions are found.
