Ocular Hypersensitivitiy to Topical Vancomycin in a Case of Chronic Endophthalmitis

Hwu, Jinn Jong; Chen, Ko Hua; Hsu, Wen-Ming; Lai, Jui‐Yang; Li, Yen Shien

doi:10.1097/01.ico.0000154386.43732.b5

Cited by 19 publications

(7 citation statements)

References 7 publications

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“…Previous reports used 4% diluted teicoplanin (12) and 0.05-5% diluted vancomycin in the patch tests (12, 13). However, the optimal concentration of vancomycin in the patch tests has not yet been established.…”

Section: Discussionmentioning

confidence: 99%

A Case of Hypersensitivity Syndrome to Both Vancomycin and Teicoplanin

et al. 2006

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Drug hypersensitivity syndrome to both vancomycin and teicoplanin has not been previously reported. We describe here a 50-yr-old male patient with vertebral osteomyelitis and epidural abscess who developed hypersensitivity syndrome to both vancomycin and teicoplanin. Skin rash, fever, eosinophilia, interstitial pneumonitis, and interstitial nephritis developed following the administration of each drug, and resolved after withdrawing the drugs and treating with high dose corticosteroids. The vertebral osteomyelitis was successfully treated with 6-week course of linezolid without further complications. Skin patch tests for vancomycin and teicoplanin was done 2 months after the recovery; a weak positive result for vancomycin (10% aq.,+at D2 and +at D4 with erythema and vesicles; ICDRG scale), and a doubtful result for teicoplanin (4% aq.-at D2 and±at D4 with macular erythema; ICDRG scale). We present this case to alert clinicians to the hypersensitivity syndrome that can result from vancomycin and teicoplanin, with possible cross-reactivity, which could potentially be life-threatening.

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Section: Discussionmentioning

confidence: 99%

A Case of Hypersensitivity Syndrome to Both Vancomycin and Teicoplanin

et al. 2006

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“…For their spectrum of action and for their capability of eye penetration glycopeptides have to be considered among the most useful molecules for the therapy of ocular infections sustained by Gram-positive bacteria [12,15,16].…”

Section: Introductionmentioning

confidence: 99%

Endophthalmitis: Gram Positive Ethiological Agents and Susceptibility to Glycopeptides

Chisari

2008

CCP

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Endophthalmitis is a serious sight-threatening condition, with a postoperative incidence of 0.13 -0.7%. This study aimed to investigate the spectrum of Gram-positive bacteria causing culture-proven endophthalmitis and their susceptibility to teicoplanin and vancomycin. At this purpose, minimum inhibitory concentrations of teicoplanin and vancomycin of Gram-positive bacteria isolated in the period 2001--2007 from vitreous cultures were determined. Staphylococcus epidermidis was the most common organisms identified (31,8 %), followed by Staphylococcus aureus, Peptococcus spp. e Bacillus spp. All bacteria were susceptible to teicoplanin and vancomycin. The two drugs showed a comparable activity against staphylococci and bacilli, while teicoplanin was more potent against streptococci and anaerobes. In conclusion, teicoplanin showed a spectrum of activity similar or even better that of vancomycin against the most common ethiological agents of postoperative endophthalmitis.

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“…A 76-yearold non-atopic man with chronic endophthalmitis caused by Propionibacterium acnes suffered from progressive pruritus, soreness, burning, photophobia, and tearing in his left eye 3 days after completing 2 weeks of treatment with 5% vancomycin eye drops [66]. A severe periorbital erosive rash and swelling of the left eyelid were also noted.…”

Section: Vancomycinmentioning

confidence: 97%

Hypersensitivity Reactions to Ophthalmic Products

Ventura

Viola

Gaeta

et al. 2006

CPD

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Adverse reactions after administration of ophthalmic products have frequently been observed. These reactions can be provoked by both active principles and excipients. Different pathogenic mechanisms have been suggested for such reactions, including immunologic ones. Basophils and mast cells participate in IgE-mediated reactions through the release of mediators like histamine and tryptase, whereas a T-cell-mediated pathogenic mechanism is involved in most delayed reactions, particularly conjunctival ones and eyelid dermatitis. Prick tests and immediate-reading intradermal tests are carried out to diagnose immediate hypersensitivity reactions, while patch tests are usually performed to evaluate delayed reactions. Other diagnostic tests, such as serum-specific IgE assays in immediate reactions, as well as delayed-reading intradermal tests and/or lymphocyte transformation tests in delayed ones, are rarely performed. In this review, particular attention is addressed to the clinical and practical aspects of both cell-mediated and IgE-mediated hypersensitivity reactions to ophthalmic products.

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Ocular Hypersensitivitiy to Topical Vancomycin in a Case of Chronic Endophthalmitis

Abstract: A case of hypersensitivity to topical vancamycin was reported. Patients who receive topical vancomycin should be informed of this possible adverse effect and instructed to contact their ophthalmologists if allergic reactions occur.

Cited by 19 publications

References 7 publications

A Case of Hypersensitivity Syndrome to Both Vancomycin and Teicoplanin

A Case of Hypersensitivity Syndrome to Both Vancomycin and Teicoplanin

Endophthalmitis: Gram Positive Ethiological Agents and Susceptibility to Glycopeptides

Hypersensitivity Reactions to Ophthalmic Products

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