infectious diseases
Vancomycin
Adverse Effects ofVancomycin
Themain concernwithvancomycinis Hypersensitivity (allergic or due to direct mast-cell degranulation) Vancomycinshould be infused slowly in a dilute solution (2.5 to 5.0 mg/mL) over 60 minutes or more and at a rate no greater than 10 mg/minute to avoidvancomycininfusion reaction (a histamine-mediated reaction that can cause pruritus and flushing on the face, neck, and shoulders). Other hypersensitivity reactions (eg, rash, fever) may occur, especially when therapy lasts for>2 weeks. Other potential adverse effectsinclude reversible neutropenia and thrombocytopenia. Nephrotoxicity is rare unless high doses are used or other nephrotoxins (eg, aminoglycosides) are given concomitantly. Some reports suggest that concomitant use ofpiperacillin/tazobactammay also increase risk of nephrotoxicity. Phlebitis occurs uncommonly during IV infusion. Dose-related ototoxicity is unusual with current formulations; incidence is increased whenvancomycinis given concurrently with other ototoxic drugs. 