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Sharifzadeh S, Mohammadpour AH, Tavanaee A, Elyasi S. Antibacterial antibiotic-induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome: a literature review. Eur J Clin Pharmacol 2020; 77:275-289. [PMID: 33025080 PMCID: PMC7537982 DOI: 10.1007/s00228-020-03005-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 09/18/2020] [Indexed: 02/06/2023]
Abstract
Background Drug reaction with eosinophilia and systemic symptoms syndrome (DRESS) is a delayed infrequent potentially life-threatening idiosyncratic drug reaction. Aromatic anticonvulsants and allopurinol are the most frequent causative agents. However, various reports of antibiotic-induced DRESS are available. In this review, we try to summarize reports of antibacterial antibiotic-induced DRESS focusing on characteristics of DRESS induced by each antibiotic group. Methods The data were collected by searching PubMed/MEDLINE and ScienceDirect. The keywords used as search terms were “DRESS syndrome,” “drug-induced hypersensitivity syndrome (DIHS),” “antibiotics,” “antimicrobial,” and names of various antimicrobial groups. Finally, 254 relevant cases with a definite or probable diagnosis of DRESS based on RegiSCAR criteria were found until 30 May 2020 and reviewed. Results and conclusion Totally, 254 cases of antibacterial antibiotic-induced DRESS are reported. Most of them are related to antituberculosis drugs, vancomycin, and sulfonamides, respectively. Rash and fever were most frequent clinical findings. Eosinophilia and liver injury were the most reported hematologic and visceral organ involvement, respectively. Most of the patients are managed with systemic corticosteroids. The death occurred in 16 patients which most of them experienced liver or lung involvement. The reactivation of various viruses especially HHV-6 is reported in 33 cases. The mean latency period was 29 days. It is necessary to perform thorough epidemiological, genetic, and immunological studies, also systematic case review and causality assessment, as well as well-designed clinical trials for better management of antibiotic-induced DRESS. Electronic supplementary material The online version of this article (10.1007/s00228-020-03005-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shiva Sharifzadeh
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, P.O. Box 91775-1365, Mashhad, Iran
| | - Amir Hooshang Mohammadpour
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, P.O. Box 91775-1365, Mashhad, Iran
- Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ashraf Tavanaee
- Department of Infectious Disease, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sepideh Elyasi
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, P.O. Box 91775-1365, Mashhad, Iran.
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Vancomycin-associated drug-induced hypersensitivity syndrome. J Am Acad Dermatol 2019; 81:123-128. [DOI: 10.1016/j.jaad.2019.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 01/13/2019] [Accepted: 02/01/2019] [Indexed: 12/17/2022]
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Wilcox O, Hassanein M, Armstrong J, Kassis N. Case report: atypical presentation of vancomycin induced DRESS syndrome: a case report and review of the literature. BMC Pulm Med 2017; 17:217. [PMID: 29282040 PMCID: PMC5745618 DOI: 10.1186/s12890-017-0564-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 12/15/2017] [Indexed: 12/18/2022] Open
Abstract
Background Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe hypersensitivity drug reaction involving the skin and multiple internal organ systems. The symptoms typically present with fever and skin rash, and rapidly progress to multiple organ failures. Vancomycin is a rare drug to cause DRESS syndrome with 23 cases reported to date. Case presentation We described a case of a 39 year-old man who was treated with vancomycin for osteomyelitis of the foot. The patient subsequently developed acute respiratory distress syndrome (ARDS) followed by rash and acute interstitial nephritis. These symptoms were improved by withdrawal of vancomycin and a pulsed corticosteroid regimen. According to the European Registry of Severe Cutaneous Adverse Reaction Criteria (RegiSCAR) (Kardaun et al, British Journal of Dermatology, 169:1071-1080, 2013), the probability of vancomycin induced DRESS syndrome was scored as “Definite”. A literature search of vancomycin induced DRESS syndrome was also performed and the overall pulmonary involvement was estimated as 5%. To our knowledge, this was the first case reported with pulmonary involvement as the initial symptom. Conclusion This is the first case to report pulmonary manifestation as the initial symptom in vancomycin induced DRESS syndrome. Prompt recognition of this entity can expedite proper treatment and hasten recovery. Electronic supplementary material The online version of this article (10.1186/s12890-017-0564-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Olivia Wilcox
- Department of Internal Medicine, Michigan State University, East Lansing, MI, USA
| | - Mohamed Hassanein
- Department of Internal Medicine, Michigan State University, East Lansing, MI, USA
| | - John Armstrong
- Pulmonary Critical Care, Sparrow Medical Group, Lansing, MI, USA
| | - Nader Kassis
- Nephrology, Sparrow Medical Group, Lansing, MI, USA.
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Güner MD, Tuncbilek S, Akan B, Caliskan-Kartal A. Two cases with HSS/DRESS syndrome developing after prosthetic joint surgery: does vancomycin-laden bone cement play a role in this syndrome? BMJ Case Rep 2015; 2015:bcr-2014-207028. [PMID: 26021379 DOI: 10.1136/bcr-2014-207028] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
We report two cases of hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (HSS/DRESS) syndrome following systemic and local (via antibiotic laden bone cement (ALBC)) exposures to vancomycin. Both cases developed symptoms 2-4 weeks after the initiation of treatment. They responded to systemic corticosteroid treatment and were cured completely. Various drug groups may cause HSS/DRESS syndrome, and vancomycin-related cases do not exceed 2-5% of the reported cases. Almost all of these cases developed the syndrome following systemic exposure to vancomycin. ALBC seems to be the safer antibiotic administration method, as systemic antibiotic levels did not reach a toxic threshold level. However, local administration may not always be sufficient for bone-related/joint-related infections; these infections may require systemic antibiotics as well. As HSS/DRESS syndrome can mimic infectious diseases, it must be considered during differential diagnosis before suspecting failure of treatment and initiation of a different antibiotic course.
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Affiliation(s)
| | - Semra Tuncbilek
- Department of Infectious Diseases and Clinical Microbiology, Ufuk University Medical School, Ankara, Turkey
| | - Burak Akan
- Department of Orthopaedics, Ufuk University Medical School, Ankara, Turkey
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Rubinstein E, Keynan Y. Vancomycin revisited - 60 years later. Front Public Health 2014; 2:217. [PMID: 25401098 PMCID: PMC4215627 DOI: 10.3389/fpubh.2014.00217] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 10/16/2014] [Indexed: 01/13/2023] Open
Abstract
Vancomycin is one of the older antibiotics that has been now in clinical use close to 60 years. Earlier on, vancomycin was associated with many side effects including vestibular and renal, most likely due to impurities contained in early vancomycin lots. Over the years, the impurities have been removed and the compound has now far less vestibular adverse effects, but still possesses renal toxicity if administered at higher doses rendering trough serum levels of >15 mcg/mL or if administered for prolonged periods of time. Vancomycin is effective against most Gram-positive cocci and bacilli with the exception of rare organisms as well as enterococci that became vancomycin resistant, mostly Enterococcus faecium. The major use of vancomycin today is for infections caused by methicillin-resistant Staphylococcus aureus (MRSA), methicillin-resistant Staphylococcus epidermidis (MRSE) and amoxicillin-resistant enterococci. In its oral form, vancomycin is used to treat diarrhea caused by Clsotridium difficile. With S. aureus, there are only a handful of vancomycin-resistant strains. Nevertheless, a "vancomycin creep" that is slow upward trending of vancomycin MIC from <1 mcg/mL to higher values has been noted in several parts of the world, but not globally, and strains that have MIC's of 1.5-2 mcg/mL are associated with high therapeutic failure rates. This phenomenon has also been recently recognized in methicillin-susceptible S. aureus (MSSA). While vancomycin is relatively a safe agent adverse events include the "red man" syndrome, allergic reactions, and various bone marrow effects as well as nephrotoxicity. Vancomycin has been a very important tool in our therapeutic armamentarium that remained effective for many years, it is likely remain effective as long as resistance to vancomycin remains controlled.
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Affiliation(s)
- Ethan Rubinstein
- Department of Internal Medicine, University of Manitoba , Winnipeg, MB , Canada
| | - Yoav Keynan
- Department of Internal Medicine, University of Manitoba , Winnipeg, MB , Canada
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Young S, Ojaimi S, Dunckley H, Douglas MW, Kok J, Fulcher DA, Lin MW, Swaminathan S. Vancomycin-associated drug reaction with eosinophilia and systemic symptoms syndrome. Intern Med J 2014; 44:694-6. [DOI: 10.1111/imj.12462] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 01/27/2014] [Indexed: 11/29/2022]
Affiliation(s)
- S. Young
- Department of Clinical Immunology and Allergy; University of Sydney; Westmead Hospital; Sydney Australia
| | - S. Ojaimi
- Department of Clinical Immunology and Allergy; University of Sydney; Westmead Hospital; Sydney Australia
| | - H. Dunckley
- Department of Immunopathology, Institute of Clinical Pathology and Medical Research; University of Sydney; Westmead Hospital; Sydney Australia
| | - M. W. Douglas
- Storr Liver Unit, Westmead Millennium Institute; University of Sydney; Westmead Hospital; Sydney Australia
- Centre for Infectious Diseases and Microbiology, Sydney Emerging Infections and Biosecurity Institute; University of Sydney; Westmead Hospital; Sydney Australia
| | - J. Kok
- Centre for Infectious Diseases and Microbiology, Sydney Emerging Infections and Biosecurity Institute; University of Sydney; Westmead Hospital; Sydney Australia
- Centre for Research Excellence in Critical Infections; University of Sydney; Westmead Hospital; Sydney Australia
| | - D. A. Fulcher
- Department of Immunopathology, Institute of Clinical Pathology and Medical Research; University of Sydney; Westmead Hospital; Sydney Australia
- Department of Medicine; University of Sydney; Sydney Australia
| | - M.-W. Lin
- Department of Clinical Immunology and Allergy; University of Sydney; Westmead Hospital; Sydney Australia
- Department of Immunopathology, Institute of Clinical Pathology and Medical Research; University of Sydney; Westmead Hospital; Sydney Australia
- Department of Medicine; University of Sydney; Sydney Australia
| | - S. Swaminathan
- Department of Clinical Immunology and Allergy; University of Sydney; Westmead Hospital; Sydney Australia
- Department of Medicine; University of Sydney; Sydney Australia
- Department of Clinical Immunology; Blacktown Hospital; Sydney Australia
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Yazicioglu M, Elmas R, Turgut B, Genchallac T. The association between DRESS and the diminished numbers of peripheral B lymphocytes and natural killer cells. Pediatr Allergy Immunol 2012; 23:289-96. [PMID: 22432939 DOI: 10.1111/j.1399-3038.2012.01268.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a drug-induced, severe multiorgan system reaction whose exact pathogenesis remains unknown. This study aimed at evaluating specific changes in peripheral blood lymphocyte subtypes associated with DRESS during antibiotic treatment. We analyzed six patients with DRESS. A complete blood count and peripheral blood lymphocytes immunophenotyping were carried out at symptom onset and at follow-up visits. Acute-phase reactants and liver enzymes were measured in all patients. Other tests - viral serology, serum immunoglobulin levels, and skin tests were performed when possible. B-cell counts were low in all patients at the onset of DRESS, and natural killer (NK) cells were low in all cases except one. During recovery, B-cell numbers were within a normal range in five patients. In one, there was even a 10-fold increase in B-cell counts, although the level was mildly low after 3 months. NK-cell numbers were within a normal range in three patients. The mean numbers of B cells and NK cells were significantly higher in the second samples compared to the values on admission. Serum IgA and IgM levels were low in one patient. The drug provocation test was positive with cefotaxime in one patient. Viral serology, performed on five patients, was negative. A decrease in B-cell and NK-cell counts was the most consistent finding associated with the onset of antibiotic-induced DRESS in our patients. This immunologic alteration might be a useful predictor of DRESS development.
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Affiliation(s)
- Mehtap Yazicioglu
- Pediatric Allergy Division, Department of Pediatrics, Trakya University, Edirne, Turkey.
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Hsiao SH, Chou CH, Lin WL, Lee EJ, Liao LH, Chang HJ, Yeh PY, Lin CY, Wu TJ. High risk of cross-reactivity between vancomycin and sequential teicoplanin therapy. J Clin Pharm Ther 2011; 37:296-300. [DOI: 10.1111/j.1365-2710.2011.01291.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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O'Meara P, Borici-Mazi R, Morton AR, Ellis AK. DRESS with delayed onset acute interstitial nephritis and profound refractory eosinophilia secondary to Vancomycin. Allergy Asthma Clin Immunol 2011; 7:16. [PMID: 21968185 PMCID: PMC3198947 DOI: 10.1186/1710-1492-7-16] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 10/03/2011] [Indexed: 12/23/2022] Open
Abstract
Background Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a relatively rare clinical entity; even more so in response to vancomycin. Methods Case report. Results We present a severe case of vancomycin-induced DRESS syndrome, which on presentation included only skin, hematological and mild liver involvement. The patient further developed severe acute interstitial nephritis, eosinophilic pneumonitis, central nervous system (CNS) involvement and worsening hematological abnormalities despite immediate discontinuation of vancomycin and parenteral corticosteroids. High-dose corticosteroids for a prolonged period were necessary and tapering of steroids a challenge due to rebound-eosinophilia and skin involvement. Conclusion Patients with DRESS who are relatively resistant to corticosteroids with delayed onset of certain organ involvement should be treated with a more prolonged corticosteroid tapering schedule. Vancomycin is increasingly being recognized as a culprit agent in this syndrome.
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Affiliation(s)
- Paloma O'Meara
- Department of Medicine, Queen's University, Kingston, Ontario, Canada.
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An SY, Hwang EK, Kim JH, Kim JE, Jin HJ, Jin SM, Kyun JO, Lee YH, Park HS, Choi YW, Lim SK, Ye YM. Vancomycin-associated spontaneous cutaneous adverse drug reactions. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2011; 3:194-8. [PMID: 21738885 PMCID: PMC3121061 DOI: 10.4168/aair.2011.3.3.194] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Accepted: 03/25/2011] [Indexed: 11/30/2022]
Abstract
Purpose 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.
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Affiliation(s)
- So-Yeon An
- Ajou Regional Pharmacovigilance Center, Ajou University Hospital, Suwon, Korea
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Drug-induced lymphadenopathy with eosinophilia and renal failure mimicking lymphoma disease: dramatic onset of DRESS syndrome associated with antibiotic treatment. Ann Hematol 2011; 90:1353-5. [PMID: 21298267 DOI: 10.1007/s00277-011-1170-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2011] [Accepted: 01/21/2011] [Indexed: 10/18/2022]
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Hsiao SH, Chen HH, Chou CH, Lin WL, Liu Yeh PY, Wu TJ. Teicoplanin-induced hypersensitivity syndrome with a preceding vancomycin-induced neutropenia: a case report and literature review. J Clin Pharm Ther 2010; 35:729-32. [DOI: 10.1111/j.1365-2710.2009.01124.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Min KS, Choi WY, Song ES, Han DK, Cho YK, Ma JS. A case of vancomycin-induced drug hypersensitivity syndrome. KOREAN JOURNAL OF PEDIATRICS 2008. [DOI: 10.3345/kjp.2008.51.11.1228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kyung Sun Min
- Department of Pediatrics, Chonnam National University Medical School, Gwang-Ju, Korea
| | - Woo Yeon Choi
- Department of Pediatrics, Chonnam National University Medical School, Gwang-Ju, Korea
| | - Eun Song Song
- Department of Pediatrics, Chonnam National University Medical School, Gwang-Ju, Korea
| | - Dong Kyun Han
- Department of Pediatrics, Chonnam National University Medical School, Gwang-Ju, Korea
| | - Young Kuk Cho
- Department of Pediatrics, Chonnam National University Medical School, Gwang-Ju, Korea
| | - Jae Sook Ma
- Department of Pediatrics, Chonnam National University Medical School, Gwang-Ju, Korea
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2006. [DOI: 10.1002/pds.1176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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