Abstract

SCOLARI, Mariano; TROVATO, Daiana; KOT, Lilian  and  ERNST, Glenda. Adverse drug reactions to multiple antibiotics. Medicina (B. Aires) [online]. 2023, vol.83, n.1, pp.158-162. ISSN 0025-7680.

Adverse reaction reporting is essential to understand the actual safety of marketed medicines. There are cases of patients with multidrug intolerance syndrome, an under-reported entity, which can occur when adverse reactions to more than two pharmacologically unrelated drugs occur in the same patient. We describe the case of a woman diagnosed with multisensitive Staphylococcus aureus endocarditis who experienced adverse reactions to five structurally unrelated antibiotics with different mechanisms of action in two consecutive hospitalisations. The reactions were secondary to cefazolin (tricytopenia), vancomycin (renal injury), daptomycin (elevated creatine phosphokinase) and linezolid (hepatotoxicity) in the first hospitalization, and to cotrimoxazole (thrombocytopenia) in the second. Transient damage to different organ systems was observed in all cases. Finally, hospital discharge was granted with clindamycin without further intercurrences until treatment was completed. This case could cor respond to the aforementioned syndrome or to an as yet uncharacterized entity.

Keywords : Pharmacovigilance; Multiple drug intolerance syndrome; Adverse reactions to multiple antibiotics.

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