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Vancomycin anaphylaxis and successful desensitization
S Anne'1, E Middleton, R E Reisman
1Buffalo General Hospital, NY 14203.
Annals of Allergy
|November 1, 1994
Summary
Vancomycin anaphylaxis can be successfully treated with a prolonged desensitization protocol. This method allows allergic patients to receive vancomycin when no other treatment options exist.
Area of Science:
- Clinical Medicine
- Immunology
- Pharmacology
Background:
- Vancomycin is a critical antibiotic for treating serious Gram-positive bacterial infections.
- Anaphylaxis to vancomycin, though rare, presents a significant challenge in patient management.
- Alternative antibiotics may have limitations or be less effective, necessitating vancomycin use.
Observation:
- A 35-year-old woman experienced anaphylaxis, including urticaria and respiratory distress, upon vancomycin re-administration.
- Standard desensitization protocols and supportive medications failed to prevent recurrent allergic reactions.
- Intradermal skin testing revealed hypersensitivity to vancomycin at very low concentrations.
Findings:
- A 13-day sequential intravenous vancomycin dose escalation protocol successfully desensitized the patient.
- Following desensitization, the patient tolerated the full therapeutic dose of vancomycin.
- Skin test reactivity to vancomycin diminished after successful desensitization.
Implications:
- Prolonged vancomycin desensitization is a viable strategy for managing patients with confirmed anaphylaxis.
- This approach offers a crucial treatment option when alternative antibiotics are unsuitable.
- Further research into optimizing desensitization protocols for vancomycin hypersensitivity is warranted.