静脉滴注万古霉素致视力下降一例

Visual acuity decline caused by intravenous infusion of vancomycin:a case report

本文报道1例63岁男性患者因感染性心内膜炎于外院使用万古霉素联合美罗培南治疗,9 d后病情好转,因抗感染疗程不足,收治入院调整为万古霉素治疗。用药8 d后,患者出现视物模糊、视力下降,临床药师考虑为万古霉素引起,建议停用该药,调整为利奈唑胺,给予妥布霉素地塞米松滴眼液,2 d后症状好转,10 d后症状完全消失。静脉滴注万古霉素导致眼部不良反应少见,但可导致严重后果,应引起临床重视,提高用药安全。

This article reported a case of a 63-year-old male patient who was initially treated with vancomycin combined with meropenem for infective endocarditis in another hospital.After 9 days,the patient's condition improved.However,due to insufficient antimicrobial therapy,he was transferred to our hospital,where vancomycin was continued.After 8 days of treatment,the patient developed blurred vision and decreased visual acuity,which was considered to be caused by vancomycin.The clinical pharmacist advised discontinuation of vancomycin and the patient was switched to linezolid and tobramycin dexamethasone eye drops were administered.The above symptoms improved after 2 days of drug withdrawal and returned to normal after 10 days of drug withdrawal.Although ocular adverse reactions to intravenous vancomycin infusion are rare,they can lead to serious consequences,and clinical attention should be paid to improve drug safety.