1例儿童口服万古霉素治疗艰难梭菌感染引起面部皮疹并文献复习

目的:探讨口服万古霉素治疗儿童艰难梭菌感染的不良反应及原因。方法:结合1例儿童口服万古霉素治疗艰难梭菌感染引起面部皮疹的案例,检索并分析国内外口服万古霉素发生不良反应的文献。结果:万古霉素口服给药可发生与静脉给药类似的不良反应,考虑与万古霉素在肠道吸收有关,且高剂量、长疗程、合并严重的肠道炎症性疾病、肾功能异常、禁食和腹泻等均为引起万古霉素肠道吸收增加的高风险因素。结论:药师在临床实施药学监护时,需警惕万古霉素口服给药可能发生的不良反应,必要时可采用血药浓度监测以保证临床用药安全。

A Case of Rash Induced by Oral Vancomycin in the Treatment of Clostridium Difficile Infection and Literature Review

Objective: To probe into the adverse drug reactions and causes of oral vancomycin in the treatment of Clostridium difficile infection. Methods: Combined with a case of rash induced by oral vancomycin in the treatment of Clostridium difficile infection, the literature on adverse drug reactions of oral vancomycin at home and abroad were retrieved and analyzed. Results: Oral administration of vancomycin might cause adverse drug reactions similar to those of intravenous administration, which was considered to be related to the absorption of vancomycin in the intestine. High-dose, long-term treatment, severe intestinal inflammatory disease, abnormal renal function, fasting and diarrhea are all high-risk factors for increased intestinal absorption of vancomycin. Conclusion: Pharmacists should be alert to the possible adverse drug reactions of oral vancomycin during clinical pharmaceutical care, and if necessary, blood drug concentration monitoring can be used to ensure the safety of clinical medication.