Vancomycin-Induced Neutropenia With Subsequent Perioperative Readministration: A Case Report

TL;DR

A 25-year-old male developed neutropenia from vancomycin but was safely readministered it later for surgery, highlighting the need for careful monitoring and risk assessment.

Contribution

Demonstrates the feasibility of vancomycin readministration after neutropenia with cautious evaluation.

Findings

Neutropenia occurred earlier than previously reported during vancomycin therapy.

Readministration of vancomycin was possible without recurrence of neutropenia.

Careful risk assessment is crucial for managing vancomycin-induced neutropenia.

Abstract

Vancomycin (VCM), an essential antibiotic for antimicrobial-resistant Gram-positive cocci, can lead to complications such as neutropenia. Here, we present a case of a 25-year-old male with noncommunicating hydrocephalus due to an intraventricular tumor who developed neutropenia during VCM therapy. Despite the suspected VCM-induced neutropenia, short-term readministration was deemed necessary for perioperative infection prophylaxis. This patient was readministered without neutropenia. A review of the literature revealed an earlier onset of VCM-induced neutropenia than that previously reported, emphasizing the importance of vigilant monitoring. Although readministration of VCM in patients with neutropenia is uncommon, it may be feasible with careful risk assessment, particularly in cases of mild neutropenia and short-term therapy. However, the mechanisms underlying VCM-induced neutropenia remain unclear, necessitating further research on the optimal management strategies.

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