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OBJECTIVE To accurately identify the rare adverse drug reactions （ADR） of vancomycin-pancytopenia in order to promote its safe use. METHODS Through a case report of a child with suppurative hip arthritis who developed pancytopenia combined with delayed drug fever caused by intravenous infusion of vancomycin，Naranjo score method and related literature were used to summarize the association between the ADR and vancomycin and its possible mechanism， and suggestions for rational use of vancomycin in pediatric patients were put forward. RESULTS & CONCLUSIONS The association of pancytopenia combined with delayed drug fever and vancomycin in this child is “very likely”. In clinical practice， it is difficult to distinguish between pancytopenia combined with delayed drug fever from fever and hematopenia caused by aggravation of infection. Medical staff should increase their awareness of vancomycin rare ADR such as pancytopenia， and pharmacists should assist medical staff in timely screening for ADR. The initial dose of vancomycin infusion for children should start from 60 mg/（kg·d），and the blood concentration should be monitored 48 h after the first infusion and the dose should be adjusted in time to maintain the valley concentration of vancomycin at 5-15 mg/L to prevent the occurrence of ADR caused by excessive blood concentration. For children who have been using vancomycin for more than one week，the blood routine should be rechecked regularly. Once pancytopenia occurs，the drug should be stopped immediately，and symptomatic treatment should be given according to the situation.
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OBJECTIVE:To provide reference for the timely and accurate judgment of drug fever induced by Piperacillin sodi-um and tazobactam sodium for injection and rational drug use in the clinic. METHODS:The medication,clinical manifestations, laboratory examination results and the physician treatment of 30 inpatients with drug fever induced by Piperacillin sodium and tazo-bactam sodium for injection from Sept. 2013 to Sept. 2014 were analyzed retrospectively and statistically. RESULTS:Most of the drug fever induced by Piperacillin sodium and tazobactam sodium for injection occurred in continuous 7 to 14 d medication,and the cumulative dosages were between 1.3 to 2.7 g/kg;73.3% of the 30 patients had fever during the intravenous drip,with body temperature mainly≥38.5 ℃;the elevation of eosinophil and slightly increase of serum C-reactive protein (CRP) and blood cell sedimentation rate (ESR) could be used as observation indexes of drug fever,but the leucocyte reduce could’t be suitable;the body temperature dropped to normal within 24 to 48 hours after stopped using it. CONCLUSIONS:The drug fever induced by Piperacillin sodium and tazobactam sodium for injection has no correlation with the patients’gender or age,and no special diagnos-tic criteria. But it has certain correlation with duration of medication,cumulative days and dosages and it can be used as reference of judgment with the combination of hematological examination index. Clinicians should improve the understanding and attention about drug fever to stop using suspicious drug in time.
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One case of schistosomiasis got drug fever after taking praziquantel.
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Objective To analyse the clinical characteristics of drug-fever caused by ?-lactams antibiotics and provide the basic information for diagnosis of patients with drug-fever,and profile the drug fever due to antimicrobil agent.Methods In this study,64 hospitalized cases between 2000 and 2006 were enrolled who had drug-fever during antiinfective treatment.Results Most medications can cause fever,so as ?-lactams Antibiotics,with or without concomitant clinical manifestations.The fever could arise from the drug's pharmacologic action,its effects on thermoregulation,a local complication following parenteral administration,or an idiosyncratic response.Patients with drug-fever caused by ?-lactams,their temperature droped to normal level while ?-lactams discontinued for about 24h~48h,and without any linger effect.Conclusions Drug-fever is mainly caused by ?-lactams antibiotics like piperacillin sodium.It is important that doctors should bear the drug-fever in mind to avoid misdiagnosis.
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OBJECTIVE:To promote physicians and pharmacists obtain thorough knowledge about drug fever and its main features,clinical manifestation and identification evidence so as to improve the level of diagnosis and treatment. METHODS:The step and process of clinical pharmacists involving in medical consultation and intervention for drug fever were introduced and related knowledge of drug fever was interpreted term-by-term. RESULTS:Drug fever was common in the process of medical diagnosis and treatment. Once occurrence time of drug fever,feature of thermal variation and accompanying body reaction were observed, the relevant diagnosis can be conducted. CONCLUSION:Clinical pharmacists involving in ward around and medical consultation contribute to medical diagnosis,treatment and patient using drug safely,effectively,economically and rationally.