Vancomycin-Induced Thrombocytopenia

When an acute decline in platelet count and bleeding occur, vancomycin- or other drug-induced thrombocytopenia should be considered.

Vancomycin is used widely in patients with Staphylococcus aureus infections or with other infections that are unresponsive to other antibiotics. A number of vancomycin-related adverse effects have been reported, including nephrotoxicity, ototoxicity, anaphylactoid reactions (“red-man syndrome”), neutropenia, and, rarely, thrombocytopenia, for which the mechanism has been obscure. However, investigators from Wisconsin and Texas now have acquired data on 34 patients with vancomycin-related thrombocytopenia.

Vancomycin-related thrombocytopenia was associated with platelet counts as low as 13,600 per μL and with severe bleeding. When the drug was withdrawn, platelet counts returned to normal in all patients; however, two patients who received se…

Reviewing Author

David Green, MD, PhD