| DOI: https://doi.org/10.14456/mujps.2015.22 | Pharm Sci Asia 2015; 42(4), 178-185 |
Prevalence and related factors for injectable vancomycin or teicoplanin-associated thrombocytopenia in a Vietnamese hospitalHT. Nguyen1, T. Pham2, HT. Bui*
1 Department of Clinical Pharmacy, Faculty of Pharmacy, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
2 Department of Pharmacy, Thong Nhat Hospital, Ho Chi Minh City, Vietnam
Thrombocytopenia is a rare but dangerous adverse event when using vancomycin and teicoplanin. The objectives of this study were to evaluate the prevalence and related factors for vancomycin or teicoplanin injection associated thrombocytopenia. We conducted a cross-sectional study based on medical records of all patients aged 18 years and over, who were treated for at least 48 hours with vancomycin or teicoplanin injection at Thong Nhat hospital. Patients using oral vancomycin, or who had blood system disorders or platelet reduction associated with an original disease were excluded from this study. Thrombocytopenia was defined as a decrease in platelet count at least 25% from baseline and lower than 100 x 109/L. Thrombocytopenia was observed in 16.2% of patients received vancomycin and 21.9% of patients received teicoplanin (p = 0.292). For vancomycin-associated thrombocytopenia, related factor was sex (male) (OR 5.740; 95% CI 1.155-29.547; p = 0.037) and the appropriateness of drug dosing was a protective factor (OR 0.140; 95% CI 0.031-0.628; p = 0.010). For teicoplanin-associated thrombocytopenia, related factor was treatment in the ICU (OR 5.054; 95% CI 1.077-23.791; p = 0.040) and protective factor was baseline platelet count (? 142 x 109/L) (OR 0.267; 95% CI 0.087-0.823; p = 0.021). Patients treated with injectable vancomycin or teicoplanin should be monitored the number of platelets before and during treatment to minimize the consequences of thrombocytopenia. Dose adjustment should be considered in patients received vancomycin, especially in male. Teicoplanin should be more carefully indicated in patients in ICU department with a low platelet count.
Keyword:
vancomycin injection, teicoplanin injection, thrombocytopenia
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