Farber B F, Moellering R C
Antimicrob Agents Chemother. 1983 Jan;23(1):138-41. doi: 10.1128/AAC.23.1.138.
A retrospective chart review of 98 patients treated with 100 courses of intravenous vancomycin was undertaken to better define its toxicity. Most of the patients carried diagnoses of Staphylococcus aureus or Staphylococcus epidermidis infection. Auditory toxicity was not seen, and fever and rash occurred in only 1 to 3% of the subjects. Phlebitis was noted in 13% of the cases and required discontinuation of therapy in 2%. Therapy was complicated by neutropenia (polymorphonuclear leukocyte count, less than or equal to 1,000 cells per cm3) in 2% of the patients but was rapidly reversible. Nephrotoxicity was uncommon (5%) and reversible in subjects receiving vancomycin alone, even when the therapy was continued. However, 35% of the patients receiving vancomycin with an aminoglycoside developed significant elevations in serum creatinine. Although this high incidence may have been due to the patient population selected or to the aminoglycoside therapy alone, the possibility of additive toxicity between vancomycin and the aminoglycosides should be considered.
对98例接受100疗程静脉注射万古霉素治疗的患者进行了回顾性病历审查,以更好地确定其毒性。大多数患者被诊断为金黄色葡萄球菌或表皮葡萄球菌感染。未观察到听觉毒性,仅1%至3%的受试者出现发热和皮疹。13%的病例出现静脉炎,2%的病例需要停药。2%的患者治疗出现中性粒细胞减少(多形核白细胞计数,小于或等于每立方厘米1000个细胞),但可迅速逆转。肾毒性不常见(5%),在单独接受万古霉素治疗的受试者中是可逆的,即使继续治疗也是如此。然而,35%接受万古霉素与氨基糖苷类联合治疗的患者血清肌酐显著升高。尽管这种高发生率可能是由于所选患者群体或仅因氨基糖苷类治疗,但应考虑万古霉素与氨基糖苷类之间存在相加毒性的可能性。