Incidence and risk factors of Vancomycin-induced thrombocytopenia: a six-year real-world study

Abstract Objectives Drug-induced thrombocytopenia has been reported for numerous drugs. Vancomycin-induced thrombocytopenia (VIT) is infrequently and often under-recognized. VIT can lead to the serious consequences of some life-threatening bleeding, especially in high-risk population. However, few s...

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Main Authors: Yuanchao Zhu, Lishuang Huang, Jingjing Zhang, Liang Liang, Pengfei Jin
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Infectious Diseases
Subjects:
Online Access:https://doi.org/10.1186/s12879-024-10393-1
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author Yuanchao Zhu
Lishuang Huang
Jingjing Zhang
Liang Liang
Pengfei Jin
author_facet Yuanchao Zhu
Lishuang Huang
Jingjing Zhang
Liang Liang
Pengfei Jin
author_sort Yuanchao Zhu
collection DOAJ
description Abstract Objectives Drug-induced thrombocytopenia has been reported for numerous drugs. Vancomycin-induced thrombocytopenia (VIT) is infrequently and often under-recognized. VIT can lead to the serious consequences of some life-threatening bleeding, especially in high-risk population. However, few studies have focused on VIT. This study aimed to describe the occurrence and manifestation of VIT and evaluate its risk factors in real-world settings. Methods A retrospective case-control study of patients treated with intravenous vancomycin was conducted between January 2018 and December 2023. Results Among the 1269 identified patients, the incidence of thrombocytopenia was 3.3% (42/1269) after a medium of 9 days (range, 2 to 22) of the initiation of vancomycin therapy. Twenty-four patients experienced platelet recovery, and all recovered after discontinuing vancomycin, with a mean duration of 9 days (range, 1 to 35) after vancomycin cessation. The severity of thrombocytopenia varied among these patients, with 45.2% (19/42) experiencing Grade 3 to Grade 4 thrombocytopenia. Multivariate analysis indicated that risk factors for VIT were qSOFA score ≥ 2, underlying renal diseases, duration of vancomycin therapy ≥ 8 days, PLT ≤ 150 × 109/L, and BUN ≥ 12 mmol/L. In the retrospective cohort, among patients with 0–5 risk factors, the incidence rates of VIT were 0.2% (1/556), 1.6% (7/439), 5.8% (10/173), 14.9% (11/74), 42.1% (8/19), and 62.5% (5/8) respectively. Conclusion It is crucial for medical staff to remain vigilant and carefully observe any signs of potential bleeding throughout vancomycin therapy, especially in those with more than 3 combined risk factors.
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spelling doaj-art-28cd52f60f2e456dbafc6855aae053ba2025-01-05T12:09:41ZengBMCBMC Infectious Diseases1471-23342025-01-0125111010.1186/s12879-024-10393-1Incidence and risk factors of Vancomycin-induced thrombocytopenia: a six-year real-world studyYuanchao Zhu0Lishuang Huang1Jingjing Zhang2Liang Liang3Pengfei Jin4Department of Pharmacy, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application Beijing HospitalTangshan Gongren HospitalWeifang People’s HospitalDepartment of Pharmacy, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application Beijing HospitalDepartment of Pharmacy, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application Beijing HospitalAbstract Objectives Drug-induced thrombocytopenia has been reported for numerous drugs. Vancomycin-induced thrombocytopenia (VIT) is infrequently and often under-recognized. VIT can lead to the serious consequences of some life-threatening bleeding, especially in high-risk population. However, few studies have focused on VIT. This study aimed to describe the occurrence and manifestation of VIT and evaluate its risk factors in real-world settings. Methods A retrospective case-control study of patients treated with intravenous vancomycin was conducted between January 2018 and December 2023. Results Among the 1269 identified patients, the incidence of thrombocytopenia was 3.3% (42/1269) after a medium of 9 days (range, 2 to 22) of the initiation of vancomycin therapy. Twenty-four patients experienced platelet recovery, and all recovered after discontinuing vancomycin, with a mean duration of 9 days (range, 1 to 35) after vancomycin cessation. The severity of thrombocytopenia varied among these patients, with 45.2% (19/42) experiencing Grade 3 to Grade 4 thrombocytopenia. Multivariate analysis indicated that risk factors for VIT were qSOFA score ≥ 2, underlying renal diseases, duration of vancomycin therapy ≥ 8 days, PLT ≤ 150 × 109/L, and BUN ≥ 12 mmol/L. In the retrospective cohort, among patients with 0–5 risk factors, the incidence rates of VIT were 0.2% (1/556), 1.6% (7/439), 5.8% (10/173), 14.9% (11/74), 42.1% (8/19), and 62.5% (5/8) respectively. Conclusion It is crucial for medical staff to remain vigilant and carefully observe any signs of potential bleeding throughout vancomycin therapy, especially in those with more than 3 combined risk factors.https://doi.org/10.1186/s12879-024-10393-1VancomycinThrombocytopeniaBleedingRisk factors
spellingShingle Yuanchao Zhu
Lishuang Huang
Jingjing Zhang
Liang Liang
Pengfei Jin
Incidence and risk factors of Vancomycin-induced thrombocytopenia: a six-year real-world study
BMC Infectious Diseases
Vancomycin
Thrombocytopenia
Bleeding
Risk factors
title Incidence and risk factors of Vancomycin-induced thrombocytopenia: a six-year real-world study
title_full Incidence and risk factors of Vancomycin-induced thrombocytopenia: a six-year real-world study
title_fullStr Incidence and risk factors of Vancomycin-induced thrombocytopenia: a six-year real-world study
title_full_unstemmed Incidence and risk factors of Vancomycin-induced thrombocytopenia: a six-year real-world study
title_short Incidence and risk factors of Vancomycin-induced thrombocytopenia: a six-year real-world study
title_sort incidence and risk factors of vancomycin induced thrombocytopenia a six year real world study
topic Vancomycin
Thrombocytopenia
Bleeding
Risk factors
url https://doi.org/10.1186/s12879-024-10393-1
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