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Updated: May 11, 2026
11:56
Nanomechanics of Drug-target Interactions and Antibacterial Resistance Detection
Published on: October 25, 2013
Vancomycin hypersensitivity: synergism with narcotics and "desensitization" by a rapid continuous intravenous
J T Wong1, R E Ripple, J A MacLean
1Department of Medicine, Harvard Medical School, Boston, MA.
The Journal of Allergy and Clinical Immunology
|August 1, 1994
Summary
Patients with persistent vancomycin adverse reactions can be safely treated using a rapid continuous intravenous desensitization protocol. Discontinuing narcotic administration alongside this method improves vancomycin treatment success.
Area of Science:
- Pharmacology
- Infectious Diseases
- Clinical Medicine
Background:
- Investigating persistent adverse reactions to vancomycin in patients with serious staphylococcal infections.
- Assessing contributing factors to vancomycin intolerance.
- Evaluating a rapid continuous intravenous desensitization protocol for vancomycin-resistant infections.
Observation:
- Seven patients with beta-lactam resistant staphylococcal infections experienced persistent vancomycin adverse reactions.
- Standard interventions like slowed infusion and H1-antihistamines were ineffective.
- A rapid continuous intravenous desensitization protocol was implemented using a syringe pump.
Findings:
- Most patients achieved therapeutic vancomycin infusion rates within the first day.
- A threshold vancomycin infusion rate (VIR) was identified in some patients, triggering adverse reactions.
- Discontinuation of concurrent narcotic administration was crucial for successful vancomycin treatment completion in all patients.
Implications:
- Rapid continuous intravenous desensitization is a safe and effective strategy for managing vancomycin adverse reactions.
- Identifying and discontinuing confounding factors like narcotic administration is key to successful vancomycin therapy.
- This protocol offers a viable alternative for patients intolerant to vancomycin.
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