Teicoplanin Administration in a Case of Endocarditis With Vancomycin-Induced Neutropenia

Abstract

Neutropenia is an uncommon adverse effect associated with prolonged vancomycin therapy. The vancomycin-induced neutropenia is believed to be immunologically based and independent of drug concentrations. Neutrophil counts normally recover after discontinuation of vancomycin in this situation, but treatment options are needed for those patients who require ongoing antibiotic therapy. We report an eight year-old boy with infective endocarditis and vancomycin-induced neutropenia in which the neutropenia resolved after vancomycin was replaced by the structurally related compound teicoplanin. Patients should have periodic assessment of white blood cell and neutrophil counts and discontinuation of vancomycin should be considered if neutropenia develops.