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Glycopeptide Hypersensitivity and Adverse Reactions

Vanthida Huang1, Nicola A Clayton2, Kimberly H Welker3

  • 1Department of Pharmacy Practice, Midwestern University College of Pharmacy-Glendale, Glendale, AZ 85308, USA.

Pharmacy (Basel, Switzerland)
|April 25, 2020
PubMed

Insights

Glycopeptides like vancomycin treat MRSA infections and C. difficile. Hypersensitivity reactions, including Redman Syndrome, are rare but important to recognize and manage.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Immunology

Background:

  • Glycopeptides (vancomycin, teicoplanin) and lipoglycopeptides (dalbavancin, oritavancin, telavancin) are crucial for treating MRSA infections.
  • Parenteral glycopeptides are first-line for severe MRSA, while oral vancomycin treats C. difficile infections.
  • Vancomycin serves as an alternative for patients with beta-lactam hypersensitivity.

Purpose of the Study:

  • To review and describe various hypersensitivity reactions to glycopeptides and lipoglycopeptides.
  • To differentiate true allergic reactions from infusion-related events like Redman Syndrome.
  • To discuss cross-reactivity patterns among these antimicrobial agents.

Main Methods:

  • Literature review of glycopeptide and lipoglycopeptide hypersensitivity.
  • Analysis of reported cases of immune-mediated and delayed reactions.
  • Categorization of reactions including IgE-mediated, Redman Syndrome, and linear IgA bullous dermatosis.

Main Results:

  • Common adverse effects include nephrotoxicity, ototoxicity, and Redman Syndrome (RMS).
  • RMS is a histamine-mediated infusion reaction, not a true IgE-mediated allergy.
  • Immune-mediated and delayed hypersensitivity reactions to glycopeptides are reported, with potential cross-reactivity.

Conclusions:

  • Understanding the spectrum of glycopeptide hypersensitivity is vital for safe clinical practice.
  • Distinguishing RMS from true allergy is key to appropriate patient management.
  • Awareness of cross-reactivity is important when selecting alternative therapies.
Keywords:
Redman Syndromedalbavancinglycopeptideshypersensitivitylipoglycopeptidesoritavancinteicoplanintelavancinvancomycin

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