Use of telavancin in adolescent patients with cystic fibrosis and prior intolerance to vancomycin: A case series

Adam T Bernstein; Margaret W Leigh; Jennifer L Goralski; Charles R Esther Jr; Cameron J McKinzie

doi:10.1016/j.jcf.2018.08.003

Use of telavancin in adolescent patients with cystic fibrosis and prior intolerance to vancomycin: A case series

J Cyst Fibros. 2018 Nov;17(6):e48-e50. doi: 10.1016/j.jcf.2018.08.003. Epub 2018 Aug 28.

Authors

Adam T Bernstein¹, Margaret W Leigh², Jennifer L Goralski³, Charles R Esther Jr², Cameron J McKinzie⁴

Affiliations

¹ Department of Pharmacy, University of North Carolina Medical Center, 101 Manning Drive, Campus Box 7600, Chapel Hill, NC 27514, United States.
² Division of Pediatric Pulmonology, Department of Pediatrics, University of North Carolina School of Medicine, 450-D MacNider Hall, Campus Box 7217, Chapel Hill, NC 27599-7217, United States.
³ Division of Pediatric Pulmonology, Department of Pediatrics, University of North Carolina School of Medicine, 450-D MacNider Hall, Campus Box 7217, Chapel Hill, NC 27599-7217, United States.; Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of North Carolina School of Medicine, 125 MacNider Hall, Campus Box 7005, Chapel Hill, NC 27599-7005, United States.
⁴ Department of Pharmacy, University of North Carolina Medical Center, 101 Manning Drive, Campus Box 7600, Chapel Hill, NC 27514, United States.. Electronic address: [email protected].

PMID: 30170755
DOI: 10.1016/j.jcf.2018.08.003

Abstract

The most common pathogen in pediatric cystic fibrosis (CF) patients is Staphylococcus aureus, and drug-resistant species are associated with negative outcomes. Methicillin-resistant Staphylococcus aureus (MRSA) is notoriously hard to treat because many antibiotics are not FDA approved for children and drug allergies or intolerances can prohibit the use of others. Telavancin is currently indicated for hospital-acquired pneumonia and ventilator-associated pneumonia caused by MRSA, but it has not been studied in patients with CF or in pediatrics. As a semi-synthetic derivative of vancomycin, it is unknown if cross-reactivity with telavancin occurs in patients with vancomycin hypersensitivity or intolerance. In this case series, we describe three adolescent patients with CF and previous intolerance to vancomycin who received telavancin for bronchopulmonary exacerbations.

Keywords: Child; MRSA; Pediatric; Telavancin; Vancomycin.

Published by Elsevier B.V.

Publication types

Case Reports

MeSH terms

Adolescent
Aminoglycosides* / administration & dosage
Aminoglycosides* / adverse effects
Anti-Bacterial Agents / administration & dosage
Anti-Bacterial Agents / adverse effects
Child
Cross Infection* / drug therapy
Cross Infection* / microbiology
Cystic Fibrosis* / complications
Cystic Fibrosis* / drug therapy
Cystic Fibrosis* / microbiology
Drug Hypersensitivity* / etiology
Drug Hypersensitivity* / physiopathology
Drug Hypersensitivity* / therapy
Female
Humans
Lipoglycopeptides* / administration & dosage
Lipoglycopeptides* / adverse effects
Male
Methicillin-Resistant Staphylococcus aureus* / drug effects
Methicillin-Resistant Staphylococcus aureus* / isolation & purification
Microbial Sensitivity Tests / methods
Staphylococcal Infections* / drug therapy
Staphylococcal Infections* / etiology
Staphylococcal Infections* / microbiology
Treatment Outcome
Vancomycin / adverse effects*

Substances

Aminoglycosides
Anti-Bacterial Agents
Lipoglycopeptides
Vancomycin
telavancin