title: Successful vancomycin desensitization with a combination of rapid and slow infusion methods.
abstract: Vancomycin, an antibiotic to which methicillin-resistant Staphylococcus aureus (MRSA) is sensitive, frequently induces hypersensitivity reactions. Lowering the vancomycin infusion rate and/or premedicating with antihistamine effectively reduce hypersensitivity in most cases. However, vancomycin desensitization is sometimes the only way to ensure safe use. Two types of desensitization protocols have been reported, and these utilize different infusion intervals; rapid desensitization and slow desensitization. We herein report a case of vancomycin hypersensitivity with methicillin-resistant Staphylococcus aureus infection. A combination of the two desensitization protocols, rapid desensitization followed by slow desensitization, effectively inhibited the hypersensitivity reaction during vancomycin infusion, and methicillin-resistant Staphylococcus aureus was successfully eradicated.
authors.affiliation: Department of Infectious Diseases, Graduate School of Medicine, The University of Tokyo, Hongo.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kitazawa
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ota
authors.forename: Nanae
authors.initials: N
authors.lastname: Kada
authors.forename: Yuji
authors.initials: Y
authors.lastname: Morisawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshida
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kimura
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000517:prevention & control; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000276:immunology*; D003888:Desensitization, Immunologic / Q000379:methods*; D004342:Drug Hypersensitivity / Q000628:therapy*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013211:Staphylococcus aureus / Q000187:drug effects; D014640:Vancomycin / Q000008:administration & dosage* / Q000276:immunology*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin