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Glycopeptide-induced vasculitis--cross-reactivity between vancomycin and teicoplanin
C Marshall1, A Street, K Galbraith
1Pharmacy Department, Royal Melbourne Hospital, Victoria, Australia.
The Journal of Infection
|November 20, 1998
Summary
Teicoplanin may cause vasculitic rashes in patients treated for vancomycin complications. Two patients experienced rash recurrence when switched to teicoplanin, indicating a potential cross-reactivity.
Area of Science:
- Infectious Diseases
- Dermatology
- Pharmacology
Background:
- Vancomycin is a critical antibiotic for treating serious Gram-positive bacterial infections.
- Teicoplanin, a related glycopeptide antibiotic, is an alternative for patients experiencing vancomycin-related adverse events.
Observation:
- Two patients developed a distinctive vasculitic rash during vancomycin treatment.
- The rash resolved upon discontinuation of vancomycin.
- The same vasculitic rash reappeared in both patients upon subsequent treatment with teicoplanin.
Findings:
- This case series suggests a potential link between teicoplanin and vasculitic rash.
- Recurrence of the rash upon teicoplanin re-challenge indicates possible drug-induced vasculitis.
Implications:
- Clinicians should be aware of the potential for teicoplanin-induced vasculitic rash.
- Consider alternative antibiotic classes in patients with a history of vancomycin-associated vasculitis who require glycopeptide therapy.