Daily Syndrome : Red man syndrome
Vancomycin causes several different types of hypersensitivity reactions, ranging from localized skin reactions to generalized cardiovascular collapse. The most common adverse reaction, the "red man syndrome" (RMS), is a rate-dependent infusion reaction, not a true allergic reaction
Signs and symptoms — RMS is characterized by flushing, erythema, and pruritus, usually affecting the upper body, neck, and face more than the lower body. Pains and muscle spasms in the back and chest, dyspnea, and hypotension may also occur. Otherwise unexplained hypotension has been reported
If red man syndrome appears then the vancomycin infusion should be discontinued immediately. A dose of 50 mg diphenhydramine hydrochloride intravenously or orally can abort most of the reactions. Once the rash and itching dissipate, the infusion can be resumed at a slower rate and/or at a lesser dosage. Hypotension will require intravenous fluids and, if severe, vasopressors may be needed, each intravenous dose of vancomycin should be administered over at least a 60 min interval to minimize the infusion-related adverse effects
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