Glycopeptide antibiotics and DRESS syndrome: a real world study leveraging the FDA Adverse Event Reporting System (FEARS)database

Background This study assessed the risk of Drug reaction with eosinophilia and systemic symptoms (DRESS) associated with various glycopeptide antibiotic treatments, including vancomycin and linezolid. Methods Disproportionality and Bayesian analyses were conducted on data spanning from the first quarter of 2006 to the first quarter of 2023, extracted from the Food and Drug Administration Adverse Event Reporting System, to delineate the signal discrepancies associated with glycopeptide antibiotic-induced DRESS. Results In the studied cohort, a total of 11,155,106 cases were identified, with the majority of affected individuals falling within the 18 to 44 age range. DRESS syndrome was most frequently reported in association with vancomycin and linezolid treatments. Disproportionality and Bayesian analyses revealed a strong association between vancomycin and the occurrence of DRESS. An intraclass correlation analysis comparing vancomycin and linezolid in relation to DRESS syndrome yielded a ranking with vancomycin demonstrating a higher Reporting Odds Ratio (ROR=54.21; 95% Confidence Interval [CI]: 50.00–58.78) than linezolid (ROR=4.04; 95% CI: 2.97–5.49). Additionally, the outcomes of DRESS syndrome induced by vancomycin and linezolid were observed to differ. Conclusions Utilizing data from the Food and Drug Administration Adverse Event Reporting System database, it was determined that vancomycin exhibits a significant association with Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome. Furthermore, among the glycopeptide antibiotics, vancomycin and linezolid were identified as having the highest risk of inducing DRESS syndrome. However, due to potential indication bias, additional clinical research is imperative to ascertain the safety profile of glycopeptide antibiotics conclusively.