title: Vancomycin-associated spontaneous cutaneous adverse drug reactions.
abstract: OBJECTIVE
  With the increase in vancomycin use, adverse drug reactions (ADRs) associated with vancomycin have been reported increasingly more often. However, the characteristics of cutaneous ADRs with and without systemic reactions (SRs) have not been described. This study investigated the characteristics of spontaneously reported and assessed ADRs associated with vancomycin by a pharmacovigilance center.
  
  
  METHODS
  ADRs (n=121) associated with vancomycin in 96 patients were collected from 2008 to 2009. Records from physician- and nurse-reported suspected cases of vancomycin ADRs, ADR type, latent period, and laboratory results were compared between cutaneous ADRs with and without SRs.
  
  
  RESULTS
  The main vancomycin-related ADRs were skin rashes (47.9%), hematologic abnormalities (17.36%), fever (12.4%), and elevated serum creatinine (12.4%). Significant differences were observed in latent period (days) and the mean change in eosinophils (%) between cutaneous (9.21±9.71 and 1.4±3.4, respectively) and other ADRs (14.03±11.71 and -0.5±3.5, respectively). Twelve cases of cutaneous ADRs with SRs had been initially reported as cutaneous ADRs only. Mean changes in the eosinophil count were significantly higher for cutaneous ADRs with SRs compared to those without SRs.
  
  
  CONCLUSIONS
  Skin rashes accompanied by peripheral eosinophilia, representing suspected immune-mediated delayed hypersensitivity reactions, are a common vancomycin ADR. For the early and exact detection of ADRs associated with vancomycin administration, close monitoring of laboratory tests, including complete blood counts with differential analysis, is recommended.
authors: Ajou Regional Pharmacovigilance Center, Ajou University Hospital, Suwon, Korea.
authors: So-Yeon
authors: SY
authors: An
authors: Eui-Kyung
authors: EK
authors: Hwang
authors: Joo-Hee
authors: JH
authors: Kim
authors: Jeong-Eun
authors: JE
authors: Kim
authors: Hyun-Jung
authors: HJ
authors: Jin
authors: Sun-Min
authors: SM
authors: Jin
authors: Jin-Ok
authors: JO
authors: Kyun
authors: Young-Hee
authors: YH
authors: Lee
authors: Hae-Sim
authors: HS
authors: Park
authors: Young Wha
authors: YW
authors: Choi
authors: Seung-Kwan
authors: SK
authors: Lim
authors: Young-Min
authors: YM
authors: Ye