Opportunities of vancomycin yesterday and today
Abstract
Vancomycin is one of the oldest antibiotics that has been used in clinical practice for about 70 years. Currently, vancomycin is mainly prescribed for the treatment of infections caused by methicillin-resistant Staphylococcus (S.) aureus, methicillin-resistant epidermal staphylococcus, and amoxicillin-resistant enterococci, and in oral form for the treatment of diarrhea caused by Clostridium difficile. Vancomycin is effective against most gram-positive cocci and bacilli, with the exception of rare organisms and enterococci that have become resistant to vancomycin, mainly Enterococcus faecium. Previously, vancomycin was associated with many side effects, including vestibular and renal, due to impurities contained in its early formulations. Over the years, the impurities have been removed, and vancomycin now has far fewer vestibular side effects, but can still cause nephrotoxicity at higher doses or when used over a long period. Currently, vancomycin is considered a relatively safe drug, adverse events are manifested due to red man syndrome. Other adverse effects of vancomycin include neutropenia, prostatitis, phlebitis, ototoxicity, thrombocytopenia, interstitial nephritis, lacrimation, linear IgA bullous dermatosis, necrotizing cutaneous vasculitis, and toxic epidermal necrolysis. Vancomycin has been a valuable agent in the treatment of infections for many decades and is still used today as the main glycopeptide antibiotic against methicillin-resistant S. aureus, methicillin-resistant epidermal staphylococcus, and enterococci susceptible to vancomycin. It is likely to remain effective as long as resistance to vancomycin remains controlled until other drugs with higher efficacy and fewer side effects become available. However, despite several decades of use, our knowledge of the side effects of vancomycin still needs to be completed. During its 70-year “life”, the pharmacological analysis of its safety has changed significantly. Therefore, this article summarizes the current information about the side effects of vancomycin, especially measures in case of its overdose, as well as features of supportive therapy.
Downloads
References
Alharbi H. H., Al-Qurainees G. I., & Al-Hebshi A. (2022). Vancomycin-Induced Fever and Neutropenia in an Immunocompetent Patient With Complicated Community-Acquired Pneumonia. Cureus, 14(7), e26630. https://doi.org/10.7759/cureus.26630
Arroyo-Mercado F., Khudyakov A., Chawla G. S., et al. (2019). Red Man Syndrome with Oral Vancomycin: A Case Report. American Journal of Medical Case Reports, 7(1), 16–17. http://dx.doi.org/10.12691/ajmcr-7-1-5
Bailey P., & Gray H. (2008). An elderly woman with ‘Red Man Syndrome’ in association with oral vancomycin therapy: a case report. Cases Journal, 1(1), 111. https://doi.org/10.1186/1757-1626-1-111
Ben M’rad M., Leclerc-Mercier S., Blanche P., et al. (2009). Drug-induced hypersensitivity syndrome: clinical and biologic disease patterns in 24 patients. Medicine (Baltimore), 88(3), 131–140. https://doi.org/10.1097/md.0b013e3181a4d1a1
Bertolissi M., Bassi F., Cecotti R., et al. (2002). Pruritus: a useful sign for predicting the haemodynamic changes that occur following administration of vancomycin. Critical Care, 6(3), 234-239. https://doi.org/10.1186/cc1495
Black E., Lau T. T., & Ensom M. H. (2011). Vancomycin-induced neutropenia: is it dose- or duration-related? Annals of Pharmacotherapy, 45(5), 629–638. https://doi.org/10.1345/aph.1p583
Filippone E. J., Kraft W. K., & Farber J. L. (2017). The Nephrotoxicity of Vancomycin. Clinical Pharmacology & Therapeutics, 102(3), 459–469. https://doi.org/10.1002/cpt.726
Ganetsky A., Han J. H., Hughes M. E., et al. (2019). Oral Vancomycin Prophylaxis Is Highly Effective in Preventing Clostridium difficile Infection in Allogeneic Hematopoietic Cell Transplant Recipients. Clinical Infectious Diseases, 68(12), 2003–2009. https://doi.org/10.1093/cid/ciy822
Hassaballa H., Mallick N., & Orlowski J. (2000). Vancomycin anaphylaxis in a patient with vancomycin-induced red man syndrome. American Journal of Therapeutics, 7(5), 319–320. https://doi.org/10.1097/00045391-200007050-00010
Humphrey C., Veve M. P., Walker B., & Shorman M. A. (2019). Long-term vancomycin use had low risk of ototoxicity. PLoS One, 14(11), e0224561. https://doi.org/10.1371/journal.pone.0224561
Jeffres M. N., Isakow W., Doherty J. A., et al. (2007). A retrospective analysis of possible renal toxicity associated with vancomycin in patients with health care-associated methicillin-resistant Staphylococcus aureus pneumonia. Clinical Therapeutics, 29(6), 1107–1115. https://doi.org/10.1016/j.clinthera.2007.06.014
Klein P. A., & Callen J. P. (2000). Drug-induced linear IgA bullous dermatosis after vancomycin discontinuance in a patient with renal insufficiency. Journal of the American Academy of Dermatology, 42(2 Pt 2), 316–323. https://doi.org/10.1016/S0190-9622(00)90102-6
Korman T. M., Turnidge J. D., & Grayson M. L. (1997.). Risk factors for adverse cutaneous reactions associated with intravenous vancomycin. Journal of Antimicrobial Chemotherapy, 39(3), 371–381. https://doi.org/10.1093/oxfordjournals.jac.a020861
Larsson A. J., Walker K. J., Raddatz J. K., & Rotschafer J. C. (1996). The concentration-independent effect of monoexponential and biexponential decay in vancomycin concentrations on the killing of Staphylococcus aureus under aerobic and anaerobic conditions. Journal of Antimicrobial Chemotherapy, 38(4), 589–597. https://doi.org/10.1093/jac/38.4.589
Lee K. S., Lee B. M., Ryu J. H., et al. (2016). Increased vancomycin production by overexpression of MbtH-like protein in Amycolatopsis orientalis KFCC10990P. Letters in Applied Microbiology, 63(3), 222–228. https://doi.org/10.1111/lam.12617
Lintel H., & Saffaf M. (2021). Neutropenia, Thrombocytopenia, and Eosinophilia: An Unusual Triad in a Patient on Long-Term Vancomycin Therapy. American Journal of Case Reports, 22, e931647. https://doi.org/10.12659/ajcr.931647
Liu C., Bayer A., Cosgrove S. E., et al. (2011). Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children: executive summary. Clinical Infectious Diseas, 52(3), 285–292. https://doi.org/10.1093/cid/cir034
Luque Y., & Mesnard L. (2018). Néphrotoxicité de la vancomycine : fréquence et mécanismes [Vancomycin nephrotoxicity: Frequency and mechanistic aspects]. Néphrologie & Thérapeutique, 14 Suppl 1, S133–S138. [French]. https://doi.org/10.1016/j.nephro.2018.02.009
Men P., Li H. B., Zhai S. D., & Zhao R. S. (2016). Association between the AUC0-24/MIC Ratio of Vancomycin and Its Clinical Effectiveness: A Systematic Review and Meta-Analysis. PLoS One, 11(1), e0146224. https://doi.org/10.1371/journal.pone.0146224
Myers A. L., Gaedigk A., Dai H., et al. (2012). Defining risk factors for red man syndrome in children and adults. The Pediatric Infectious Disease Journal, 31(5), 464–468. https://doi.org/10.1097/inf.0b013e31824e10d7
Polk R. E., Healy D. P., Schwartz L. B., et al. (1988). Vancomycin and the red-man syndrome: pharmacodynamics of histamine release. The Journal of Infectious Diseases, 157(3), 502–507. https://doi.org/10.1093/infdis/157.3.502
Renz C. L., Thurn J. D., Finn H. A., et al. (1999). Antihistamine prophylaxis permits rapid vancomycin infusion. Critical Care Medicine, 27(9), 1732–737. https://doi.org/10.1097/00003246-199909000-00006
Rocha J. L., Kondo W., Baptista M. I., et al. (2002). Uncommon vancomycin-induced side effects. Brazilian Journal of Infectious Diseases, 6(4), 196–200. https://doi.org/10.1590/s1413-86702002000400007
Rubinstein E., & Keynan Y. (2014). Vancomycin revisited - 60 years later. Frontiers in Public Health, 2, 217. https://doi.org/10.3389/fpubh.2014.00217
Rybak M., Lomaestro B., Rotschafer J. C., et al. (2009). Therapeutic monitoring of vancomycin in adult patients: a consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists. American Journal of Health-System Pharmacy, 66(1), 82–98. https://doi.org/10.2146/ajhp080434
Schwartz M. D. (2002). Vancomycin-induced neutropenia in a patient positive for an antineutrophil antibody. Pharmacotherapy, 22(6), 783–788. https://doi.org/10.1592/phco.22.9.783.34059
Sivagnanam S., & Deleu D. (2003). Red man syndrome. Crit Care, 7(2), 119-20. https://doi.org/10.1186/cc1871
Song K. H., Kim H. B., Kim H. S., et al. (2015). Impact of area under the concentration-time curve to minimum inhibitory concentration ratio on vancomycin treatment outcomes in methicillin-resistant Staphylococcus aureus bacteraemia. International Journal of Antimicrobial Agents, 46(6), 689–695. https://doi.org/10.1016/j.ijantimicag.2015.09.010
Vandecasteele S. J., De Vriese A. S., & Tacconelli E. (2013). The pharmacokinetics and pharmacodynamics of vancomycin in clinical practice: evidence and uncertainties. Journal of Antimicrobial Chemotherapy, 68(4), 743–748. https://doi.org/10.1093/jac/dks495
Von Drygalski A., Curtis B. R., Bougie D. W., et al. (2007). Vancomycin-induced immune thrombocytopenia. The New England Journal of Medicine, 356(9), 904–910. https://doi.org/10.1056/nejmoa065066
Wallace M. R., Mascola J. R., & Oldfield E. C. 3rd. (1991). Red man syndrome: incidence, etiology, and prophylaxis. The Journal of Infectious Diseases, 164(6), 1180-1185. https://doi.org/10.1093/infdis/164.6.1180
Wazny L. D., & Daghigh B. (2001). Desensitization protocols for vancomycin hypersensitivity. Annals of Pharmacotherapy, 35(11), 1458–1464. https://doi.org/10.1345/aph.1a002
Yazganoglu K. D., Ozkaya E., Ergin-Ozcan P., & Cakar N. (2005). Vancomycin-induced drug hypersensitivity syndrome. Journal of the European Academy of Dermatology and Venereology, 19(5), 648–650. https://doi.org/10.1111/j.1468-3083.2005.01228.x
Abstract views: 84 PDF Downloads: 201
This work is licensed under a Creative Commons Attribution 4.0 International License.
ISSN 
ISSN 
