替考拉宁与盐酸万古霉素致严重水疱型药疹  

Severe vesicular rash induced by teicoplanin and vancomycin hydrochloride

作　　者：赵静[1,2] 柯会星[3] 张爱玲[1,4] 王丹丹[3] 杨莉萍[1] 

机构地区：[1]卫生和计划生育委员会北京医院药学部,100730 [2]沧州市中心医院药剂科 [3]卫生和计划生育委员会北京医院呼吸科,100730 [4]沈阳药科大学

出　　处：《药物不良反应杂志》2013年第2期102-104,共3页Adverse Drug Reactions Journal

摘　　要：1例74岁男性患者,因直肠癌根治术后出现咳嗽、咯痰、发热约1个月,先后给予拉氧头孢钠、比阿培南、莫西沙星、替考拉宁、盐酸万古霉素、利奈唑胺和达托霉素治疗。在应用替考拉宁12 d后换用莫西沙星,应用莫西沙星的第4天,患者四肢及躯干部位出现充血性皮疹伴瘙痒感。停用莫西沙星、改用盐酸万古霉素并给予抗过敏对症治疗后患者皮疹好转。应用盐酸万古霉素第8天,患者四肢再次出现红疹,停用盐酸万古霉素并换用替考拉宁。应用替考拉宁第5天患者皮疹加重,部分皮疹表面出现水泡并连接成片,换用利奈唑胺并继续抗过敏治疗,陈旧水泡逐渐吸收,未再出现新发水疱。考虑可能为替考拉宁引起的迟发型过敏反应,不排除还存在与盐酸万古霉素交叉过敏的可能。A 74-year-old male patient received latamoxef, biapenem, moxifloxacin, teicoplanin, vancomycin hydrochloride, linezolid, and daptomycin in succession for about one month of cough, expectoration, and fever after resection of rectal cancer. Teicoplanin was changed to moxifloxacin after 12 days of teicoplanin treatment. On day 4 of moxifloxacin treatment, the patient developed congestive rash and itching on his limbs and trunk. Moxifloxaciu was stopped and changed to vancomycin hydrochloride as well as anti-allergic treatment, and then the rash improved. On day 8 of vancomycin hydrochloride treatment, the patient developed rash again on his limbs. Vancomycin hydrochloride was withdrawn and changed to teicoplanin. On day 5 of teicoplanin treatment, more rash occurred and some of them developed vesicles on the surface and fused into lamella. Linezolid was given and anti-allergic treatment was continued. Old vesicles were absorbed gradually and no new vesicles reoccurred. Teicoplanin-indueed delayed-type hypersensitivity was considered. Cross allergies caused by vancomyein hydrochloride and teicoplanin could not be excluded.

关 键 词：替考拉宁 盐酸万古霉素 药疹 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]