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口服万古霉素致婴儿嗜酸性粒细胞增多症 1 例报告并文献复习

A rare case of infant eosinophilia induced by oral vancomycin: a case report and literature review.

机构信息

Department of Rheumatology and Immunology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei Province, China.

Department of Gastroenterology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei Province, China.

出版信息

J Int Med Res. 2023 Feb;51(2):3000605231156761. doi: 10.1177/03000605231156761.

Abstract

Oral vancomycin is mainly used to treat and prevent active infection. Because it is widely believed that there is a very low absorption rate via the gastrointestinal tract, reports of adverse reactions following oral vancomycin administration are rare. This case report describes for the first time a case of antibiotic-associated diarrhoea in a 2-month-old infant treated with oral vancomycin. After oral vancomycin treatment, the number of eosinophils increased significantly and the levels gradually recovered after drug withdrawal. A review and analysis of the previously reported adverse reactions caused by oral vancomycin and eosinophilia caused by vancomycin confirm the need for physicians to pay close attention to vancomycin-related adverse reactions, to monitor the required concentration and to measure eosinophil counts in patients with rash-related adverse reactions. Patients with concomitant diseases and children should be monitored for adverse events as it is possible that they have increased gastrointestinal absorption of vancomycin following oral administration. When vancomycin causes eosinophilia, fever and rash, physicians should be alert to the possibility of organ damage.

摘要

口服万古霉素主要用于治疗和预防活动性感染。由于人们普遍认为其通过胃肠道的吸收率非常低,因此口服万古霉素后不良反应的报告很少见。本病例报告首次描述了一例口服万古霉素治疗的 2 个月大婴儿出现抗生素相关性腹泻。口服万古霉素后,嗜酸性粒细胞数量显著增加,停药后逐渐恢复。对先前报道的口服万古霉素引起的不良反应和万古霉素引起的嗜酸性粒细胞增多的分析和回顾证实,医生需要密切关注与万古霉素相关的不良反应,监测所需的浓度,并测量有皮疹相关不良反应的患者的嗜酸性粒细胞计数。对于合并疾病的患者和儿童,应监测不良反应事件,因为他们在口服给药后可能会增加万古霉素的胃肠道吸收。当万古霉素引起嗜酸性粒细胞增多、发热和皮疹时,医生应警惕发生器官损伤的可能性。

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