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Vancomycin-Induced Thrombocytopenia: A Narrative Review
Mehdi Mohammadi1, Zahra Jahangard-Rafsanjani1, Amir Sarayani2
1Faculty of Pharmacy, Tehran University of Medical Sciences, Pour Sina St, District 6, Tehran, Iran.
Drug Safety
|November 17, 2016
Summary
Vancomycin can cause drug-induced thrombocytopenia, a condition of low platelet counts. Early discontinuation of vancomycin and supportive treatments can help restore normal platelet levels.
Area of Science:
- Pharmacology
- Hematology
- Drug Safety
Background:
- Thrombocytopenia is a known adverse drug reaction.
- Vancomycin is an infrequently recognized cause of drug-induced thrombocytopenia.
- Existing literature lacks comprehensive descriptions of vancomycin-induced thrombocytopenia.
Purpose of the Study:
- To systematically review and describe cases of thrombocytopenia associated with vancomycin.
- To analyze the characteristics, timing, and outcomes of vancomycin-induced thrombocytopenia.
- To inform clinical recognition and management of this adverse drug reaction.
Main Methods:
- A comprehensive literature search was performed in PubMed, Scopus, and Web of Science.
- Keywords included 'vancomycin', 'platelet', 'pancytopenia', 'thrombocytopenia', and 'bleeding'.
- English language articles published before July 2015 were included, comprising case reports, observational studies, clinical trials, letters, and case series.
Main Results:
- Thirty-nine papers detailing 30 cases of vancomycin-induced thrombocytopenia were analyzed.
- The reaction was often duration-dependent, with a mean time to platelet nadir of 8 days, and shorter intervals upon re-exposure.
- Vancomycin discontinuation led to platelet recovery within 5-6 days in most cases; vancomycin-specific antibodies were detected in a majority of tested patients.
Conclusions:
- Vancomycin is a potential cause of drug-induced thrombocytopenia.
- Prompt recognition and discontinuation of vancomycin are crucial for recovery.
- Management strategies include supportive care, and advanced therapies for refractory cases.
