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Glycopeptide Hypersensitivity and Adverse Reactions

1
Department of Pharmacy Practice, Midwestern University College of Pharmacy-Glendale, Glendale, AZ 85308, USA
2
Department of Pharmacy Services, UC Davis Health, Sacramento, CA 95817, USA
3
Department of Pharmacy Services, Mercy Gilbert Medical Center, Dignity Health, Gilbert, AZ 85297, USA
*
Author to whom correspondence should be addressed.
Pharmacy 2020, 8(2), 70; https://doi.org/10.3390/pharmacy8020070
Received: 5 January 2020 / Revised: 23 March 2020 / Accepted: 18 April 2020 / Published: 21 April 2020
(This article belongs to the Special Issue Antibiotic Allergies)
Glycopeptides, such as vancomycin and teicoplanin, are primarily used in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections, such as cellulitis, endocarditis, meningitis, pneumonia, and septicemia, and are some of the most commonly prescribed parenteral antimicrobials. Parenteral glycopeptides are first-line therapy for severe MRSA infections; however, oral vancomycin is used as a first-line treatment of Clostridioides difficile infections. Also, we currently have the longer-acting lipoglycopeptides, such as dalbavancin, oritavancin, and telavancin to our armamentarium for the treatment of MRSA infections. Lastly, vancomycin is often used as an alternative treatment for patients with β-lactam hypersensitivity. Common adverse effects associated with glycopeptide use include nephrotoxicity, ototoxicity, and Redman Syndrome (RMS). The RMS is often mistaken for a true allergy; however, it is a histamine-related infusion reaction rather than a true immunoglobulin E (IgE)-mediated allergic reaction. Although hypersensitivity to glycopeptides is rare, both immune-mediated and delayed reactions have been reported in the literature. We describe the various types of glycopeptide hypersensitivity reactions associated with glycopeptides and lipoglycopeptides, including IgE-mediated reactions, RMS, and linear immunoglobulin A bullous dermatosis, as well as describe cross-reactivity with other glycopeptides. View Full-Text
Keywords: dalbavancin; glycopeptides; hypersensitivity; lipoglycopeptides; oritavancin; Redman Syndrome; teicoplanin; telavancin; vancomycin dalbavancin; glycopeptides; hypersensitivity; lipoglycopeptides; oritavancin; Redman Syndrome; teicoplanin; telavancin; vancomycin
MDPI and ACS Style

Huang, V.; Clayton, N.A.; Welker, K.H. Glycopeptide Hypersensitivity and Adverse Reactions. Pharmacy 2020, 8, 70.

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