Teicoplanin/carbamazepine
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Teicoplanin/carbamazepine Coagulation disorder: first report *111 One month after surgical resection of a rectal adenocarcinoma, a 57-year- old man developed symptoms of septic shock. A methicillin-resistant strain of Staphylococcus aureus was cultured and therapy with teicoplanin 200 then 400 mg/day was begun. Rifampicin 200 mg/day was later added because of low serum bactericidal titres. Two to 3 weeks after the start of antibacterial therapy, haematomata were noted at teicoplanin injection sites. The patient developed Pseudomonas aeruginosa pneumonia and a catheter was inserted for administration of ceftazidime 3g bid. On the same day, the patient had major bleeding from the catheter insertion site. all puncture sites, in soft tissue and muscle and into joints. A coagulation screen revealed the presence of a circulating inhibitor of factor VIII: percentage activity of factor VIII < 1"10, partial thromboplastin time 122 sec (normal range 35-55 sec), haemoglobin 9.2 g/dl. Teicoplanin and rifampicin therapy was discontinued and phytomenadione [phytonadione] and fresh frozen plasma were administered with no response. Infusion of factors VIII and IX was also ineffective but rapid improvement occurred when corticotherapy was begun 3 weeks after the appearance of the disorder. Meanwhile. sustained bacteraemia recurred and the patient received another course of teicoplanin + gentamicin 300 mg/day (subsequently vancomycin + gentamicin). Corticotherapy was gradually reduced during this period and the patient was discharged. The patient died from S. aureus septicaemia 3 months later without relapse of the bleeding disorder. The appearance of an inhibitor of factor VIII may have been a result of treatment with rifampicin or teicoplanin or ' ... the InfectIon Hself could be responsIble for the effect'. Legrand JC. Van Der Auwera P. Bailly A. Daubresse JC. Renaux J, et al. Journal of Antimicrobial Chemotherapy 19: 850-852. Jun 1987 8 REACTIONS·' 8 Aug 1987 0157-7271/87/0808-0008/0$01.00/0 © ADIS Press
Transcript of Teicoplanin/carbamazepine
Teicoplanin/carbamazepine Coagulation disorder: first report *111
One month after surgical resection of a rectal adenocarcinoma, a 57-yearold man developed symptoms of septic shock. A methicillin-resistant strain of Staphylococcus aureus was cultured and therapy with teicoplanin 200 then 400 mg/day was begun. Rifampicin 200 mg/day was later added because of low serum bactericidal titres. Two to 3 weeks after the start of antibacterial therapy, haematomata were noted at teicoplanin injection sites. The patient developed Pseudomonas aeruginosa pneumonia and a catheter was inserted for administration of ceftazidime 3g bid.
On the same day, the patient had major bleeding from the catheter insertion site. all puncture sites, in soft tissue and muscle and into joints. A coagulation screen revealed the presence of a circulating inhibitor of factor VIII: percentage activity of factor VIII < 1"10, partial thromboplastin time 122 sec (normal range 35-55 sec), haemoglobin 9.2 g/dl.
Teicoplanin and rifampicin therapy was discontinued and phytomenadione [phytonadione] and fresh frozen plasma were administered with no response. Infusion of factors VIII and IX was also ineffective but rapid improvement occurred when corticotherapy was begun 3 weeks after the appearance of the disorder.
Meanwhile. sustained bacteraemia recurred and the patient received another course of teicoplanin + gentamicin 300 mg/day (subsequently vancomycin + gentamicin). Corticotherapy was gradually reduced during this period and the patient was discharged. The patient died from S. aureus septicaemia 3 months later without relapse of the bleeding disorder.
The appearance of an inhibitor of factor VIII may have been a result of treatment with rifampicin or teicoplanin or ' ... the InfectIon Hself could be responsIble for the effect'. Legrand JC. Van Der Auwera P. Bailly A. Daubresse JC. Renaux J, et al. Journal of Antimicrobial Chemotherapy 19: 850-852. Jun 1987
8 REACTIONS·' 8 Aug 1987 0157-7271/87/0808-0008/0$01.00/0 © ADIS Press
