Current aspects of developing vancomycin-associated dermatoses and their diagnosis

The article describes early and delayed adverse skin reactions due to the administration of vancomycin, a bactericidal antibiotic from the group of glycopeptides. The main diagnostic possibilities for the early detection of vancomycin-associated dermatoses, which, in the absence of treatment and withdrawal of the associated drug, can lead to the death of the patient, are also presented. In clinical practice, the manifestations of adverse reactions from the skin are often underestimated. This is due to the lack of awareness among clinicians about the dermatological reactions of vancomycin, compared with other adverse reactions, as well as due to the small number of studies on diagnostic and statistical aspects of the issue under consideration. At the same time, it is important to remember that skin symptoms are one of the first and obvious consequences of hypersensitivity, which means they have significant diagnostic value. Some skin manifestations, in particular, the red man syndrome, can be avoided in most cases if the nursing staff works in accordance with established schemes for the administration of vancomycin. Other reactions are unpredictable, however, medical alertness and knowledge of the variants of skin lesions from vancomycin and timely measures taken can offset the effects of hypersensitivity to the drug. Currently, simple and easy-to-use tools to determine the cause-and-effect relationships between a drug and various adverse reactions, such as the Naranjo and RegiSCAR scales (for DRESS), have been developed and should not be neglected. Determining the true cause of skin reactions is a difficult task due to the lack of unambiguous standardized approaches to early diagnosis. To date, there are no practical guidelines for the diagnosis and treatment of vancomycin-associated dermatoses, which necessitates further study of this problem.