Histamine release induced by antimicrobial agents and effects of antimicrobial agents on vancomycin-induced histamine

T Toyoguchi1, M Ebihara, F Ojima

  • 1Department of Pharmacy, Yamagata University Hospital, Japan.

Insights

Vancomycin and miconazole trigger histamine release in rat mast cells, but fluconazole does not. Fosfomycin sodium may inhibit vancomycin-induced reactions, suggesting potential therapeutic benefits.

Area of Science:

  • Pharmacology
  • Immunology
  • Toxicology

Background:

  • Anaphylactoid reactions can be associated with vancomycin and certain antifungal agents.
  • Understanding drug-induced histamine release is crucial for patient safety.

Purpose of the Study:

  • To investigate the effects of vancomycin, miconazole, and fluconazole on histamine release from rat peritoneal mast cells.
  • To determine if fosfomycin sodium, cilastatin sodium, or fluconazole can inhibit vancomycin-induced histamine release.

Main Methods:

  • Rat peritoneal mast cells were used to assess histamine release.
  • Dose-dependent effects of vancomycin, miconazole, and fluconazole were evaluated.
  • Inhibition of vancomycin-induced histamine release by other agents was tested at human-equivalent doses.

Main Results:

  • Vancomycin and miconazole induced dose-dependent histamine release.
  • Fluconazole did not provoke histamine release within the tested concentration range.
  • Fosfomycin sodium inhibited vancomycin-induced histamine release, while cilastatin sodium and fluconazole did not.

Conclusions:

  • Vancomycin and miconazole are implicated in histamine release from rat mast cells.
  • Fluconazole appears unlikely to cause histamine release.
  • Fosfomycin sodium demonstrates potential to mitigate vancomycin-induced histamine release.

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