Vancomycin

Abstract

DRESS syndrome: 15 case reports In a study of patients recruited between January 2010 and September 2019, 15 patients (10 women and 5 men) aged 29–76 years were described, who developed DRESS syndrome during treatment with vancomycin for various infections [dosages, routes, duration of treatments to reaction onsets and outcomes not stated]. The patients had culture-negative soft-tissue infection with underlying rib osteomyelitis (1 patient), methicillin-resistant Staphylococcus aureus (MRSA) right chest phlegmon, deep soft-tissue infection, underlying osteomyelitis of second rib with fracture (1 patient), MRSA and Escherichia coli bacteraemia with chest infiltrate (1 patient), MRSA wound infection leading to hip prosthesis removal and placement of vancomycin spacer (1 patient), complex ocular infection (1 patient), soft tissue cellulitis (1 patient), MRSA wound infection (1 patient), Enterococcus faecalis pyelonephritis (1 patient), ventriculitis-empirical culture negative (2 patients), post-cardiac surgery wound infection-culture negative (1 patient), Enterococcus species bacteraemia and endocarditis (1 patient), MRSA osteomyelitis (1 patient), traumatic arm injury and possible osteomyelitis (1 patient), skin and soft tissue infectionmethicillin-susceptible Staphylococcus aureus (1 patient). The patients were receiving vancomycin along with several other concomitant antibiotics. Subsequently, the patients developed DRESS syndrome. The patients were confirmed positive for HLAA*32:01. Seven of the 15 patients were treated with prednisone (6 patients) and unspecified high-dose steroids (1 patient). The Naranjo score for vancomycin in all patients was above 5 and the Regi-SCAR score was above 4. Therefore, it was confirmed that, the DRESS syndrome was associated with vancomycin.