Vancomycin Vesicle

In a 71-year-old woman with pneumonia, vesicles and bullae developed on the eighth day of antibiotic therapy that consisted of one dose of intravenous vancomycin followed by a course of nafcillin (73). 

A 52-year-old woman was given vancomycin 1 g intravenously bd and within 12 hours developed a generalized pruritic maculopapular rash (83). Over the next few days, the lesions progressively worsened and transformed into hemorrhagic and non-hemorrhagic vesicles and bullae. Mucosal surfaces, palms, and soles were spared. The skin lesions completely healed without scarring within 2 weeks of vancomycin withdrawal. There was no recurrence 5 months later. 

A 46-year-old man with promyelocytic leukemia was given tretinoin 45 mg/m plus daunorubicin 60 mg/ m /day for 3 days and cytarabine 200 mg/m /day by continuous infusion for 7 days (98). He became febrile on day 3 and was given cefotaxime and vancomycin. On day 6 he developed non-pruritic, erythematous, violaceous vesicles on the limbs and upper trunk. His temperature rose to 40°C and he gained 4.5 kg, which was attributed to a mild retinoic acid... 

Sokol, PP, Mechanism of vancomycin transport in the kidney studies in rabbit renal brush border and basolateral membrane vesicles. Am J Kidney Dis, 1991,259(3) 1283-87. 

More recently. Bong and coworkers investigated the induction of vesicle fusion mediated by a biologically inspired motif based on multiple hydrogen bonding. Vancomycin binds to d-Ala-d-Ala peptides via five hydrogen bonds. Their biomimetic system consists of a modified vancomycin glycopeptides and a lipidated o-Ala-o-Ala... 

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