Journal of Clinical Toxicology
Open Access
ISSN: 2161-0495
+44 1478 350008
ISSN: 2161-0495
+44 1478 350008
Liping Yang
Beijing Hospital, Dongcheng, P R China
Scientific Tracks Abstracts: J Clin Toxicol
Background & Objective: The glycopeptide antibiotics, vancomycin and teicoplanin, are the mainstay of therapy for severe gram-positive organisms such as methicillin-resistant Staphylococcus aureus. We report a case of Stevens�Johnson syndrome (SJS) induced by sequential therapy with teicoplanin and vancomycin, in a patient with chronic obstructive pulmonary disease (COPD). Case Summary: A 74-year-old Han Chinese with 1-year history of COPD was admitted for treatment of infective endocarditis. After teicoplanin therapy for 12 days, he developed pruritus and maculopapular over his trunk and limbs. His rash spread rapidly to most parts of the body surface area, 7 days after his anti-infection therapy was switched to vancomycin. This was stopped, but he developed SJS when teicoplanin was reintroduced. This patient recovered from his drug eruptions when both teicoplanin and vancomycin were stopped. Pharmacogenetic analyses revealed he was heterozygous with respect to 2 variants (rs2844682 of MUC21 and rs750332 of BAG6). What is new & Conclusion: Cross-reactivity between vancomycin and teicoplanin is rare. SJS attributable to sequential treatment with these 2 antibiotics has not been reported previously. Care should be taken when prescribing vancomycin in patients with a previous documented skin eruption to teicoplanin, especially in those who carry any susceptibility alleles to SJS/TEN.
Liping Yang has completed her PhD from RMIT University in Australia. She is the Vice-Director of Pharmacy Department, Beijing Hospital, a large-scale general hospital. She has published more than 90 papers in reputed journals and has been serving as an Editorial Board Member of repute. Since 2003, she has served as a Clinical Pharmacist, Senior Clinical Pharmacist, Associate Professor and Professor for the Pharmacy Department, Beijing Hospital, China. Her major interests are pharmacogenomics, drug-drug interaction, evidence-based medicine, Chinese medicine and rational drug use in clinical setting.
Email: yanglp_2000@hotmail.com