Vancomycin
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Red man syndrome: 2 case reports Two boys developed red man syndrome following rapid infusion of vancomycin to treat Streptococcus viridans infection. A 14-year-old boy was prescribed vancomycin 500mg four times a day. Vancomycin 500mg diluted in 100mL of normal saline was administered via IV infusion over 60 minutes. Soon after the first infusion he reported diffuse burning and itching, his eyelids and lips became red and swollen and he developed a rash his on arms and hands. Dimeticone administration led to resolution of his symptoms. A 3-year old boy was prescribed vancomycin 220mg every 6 hours. Vancomycin 220mg diluted in 50mL normal saline solution was administered via IV infusion over 60 minutes. He developed redness on the legs and complained of itching after the first infusion. Dimeticone was administered and his symptoms rapidly improved. Despite a subsequent dose of vancomycin being administered over a slower infusion time of 2 hours the symptoms recurred. Vancomycin was discontinued and S. viridans infection treated with amikacin and benzylpenicillin. Author comment: In the elder boy "a Naranjo algorithm was applied and a score of 7 was obtained, suggesting a "probable’’ adverse drug reaction caused by vancomycin". In the younger boy "a Naranjo algorithm was applied and a score of 11 was obtained, suggesting a "definite’’ adverse drug reaction caused by vancomycin". Bauters T, et al. Vancomycin-induced red man syndrome in pediatric oncology: still an issue?. International Journal of Clinical Pharmacy 34: 13-6, No. 1, Feb 803073381 2012 - Belgium
0114-9954/10/1410-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 14 Jul 2012 No. 1410
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