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Red Man Syndrome

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The text is the summary of recent articles on Red Man Syndrome at 75 thresold from National Library of Medicine (NLM). This information is subject to NCBI's Disclaimer and Copyright notice.


Both episodes of anaphylaxis required cardiopulmonary resuscitation, which led to a successful patient outcome [1]. atopic dermatitis also manifests Itch and erythema, and staphylococcus δ-toxin contributes to this process [2]. A diagnosis of vancomycin-associated Henoch-Schönlein variant of Vasculitis was made [3]. Since vancomycin is a commonly used antibacterial agent, clinicians are encouraged to have a heightened awareness of this rare adverse skin reaction [4]. There are 2 main types of hypersensitivity reactions associated with vancomycin [5].

The patient received vancomycin for the majority of these procedures and extended courses of vancomycin on 2 separate occasions [6]. In the present case, the patient was taken to the operating room for a prosthetic infection, and vancomycin was given after cultures were taken [7]. There have been two cases of red man syndrome (RMS), a vancomycin-specific nonimmunologic reaction, associated with IP vancomycin [8]. However, immune-mediated hypersensitivity reaction to IP vancomycin has not yet been reported [9]. A 49 year old Woman on continuous ambulatory peritoneal dialysis developed her first peritonitis episode [10].

The patient was treated with IP vancomycin once/wk for 4 weeks [11]. She experienced mild itching and flushing throughout her body for 1 day after the second treatment [12]. An allergic skin test was performed 6 weeks after the previous urticarial episode, and an intradermal skin test revealed a positive response to vancomycin [13]. It seems, from the available data, that length of stay in hospital was shorter for those in the linezolid group than the vancomycin group [14]. The daily cost of outpatient therapy was less with oral linezolid than with intravenous vancomycin [15].

Although inpatient treatment with linezolid cost more than inpatient treatment with vancomycin per day, the median length of hospital stay was three days shorter with linezolid [16]. Earlier on, vancomycin was associated with many side effects including vestibular and Renal, most likely due to impurities contained in early vancomycin lots [17]. The major use of vancomycin today is for infections caused by methicillin-resistant Staphylococcus aureus (MRSA), methicillin-resistant Staphylococcus epidermidis (MRSE) and amoxicillin-resistant enterococci [18]. In its oral form, vancomycin is used to treat diarrhea caused by Clsotridium difficile [19]. While vancomycin is relatively a safe agent adverse events include the "red man" syndrome, allergic reactions, and various Bone marrow effects as well as nephrotoxicity [20].

During infusion of vancomycin, he became diaphoretic, hypotensive, and unresponsive, and exhibited respiratory distress and a disseminated red skin rash consistent with a severe allergic reaction referred to as the red man syndrome [21]. Because the program treats outpatients only, once-daily administration of IV Antibiotics is desirable [22]. Comme le programme s’adresse uniquement à des patients externes, une administration intraveineuse (IV) uniquotidienne d’antibiotiques est souhaitée [23]. Compte tenu de ces résultats, il n’est plus recommandé de donner des doses uniquotidiennes élevées de vancomycine à titre de traitement aux patients externes [24]. However, there have been few reports of this complication during intraperitoneal (IP) treatment with vancomycin [25].

Glycopeptide antibiotic is the choice of treatment in MRSA infections [26]. It seems, from the available data, that length of stay in hospital was shorter for those in the linezolid group than the vancomycin group [27]. The daily cost of outpatient therapy was less with oral linezolid than with intravenous vancomycin [28]. Although inpatient treatment with linezolid cost more than inpatient treatment with vancomycin per day, the median length of hospital stay was three days shorter with linezolid [29]. Achievement of therapeutic trough early in the course of illness may be beneficial [30].

Serum vancomycin concentrations were measured before the second and third doses [31]. However, the Systemic exposure to vancomycin in Children administered 60 mg/kg/day was adequate, despite lower than recommended measured trough levels [32]. We measured changes in creatinine and Systemic vancomycin levels after intrawound application of 500 mg of unreconstituted VP during spine deformity correction Surgery in patients weighing more than 25 kg (patients also received routine intravenous cephalosporin prophylaxis) [33]. The postoperative Systemic vancomycin levels remained undetectable [34]. However, vancomycin requires a prolonged administration time, risks promoting further antibiotic resistance, and can cause Systemic toxicity [35].

The patient was readmitted to the hospital 2 months later for MRSA bacteremia and was rechallenged with vancomycin [36]. This syndrome is classically associated with vancomycin infusion and is the result of non-IgE mediated mast cell degranulation [37]. The occurrence of adverse reactions reported was evaluated in Medical records relating to patients taking vancomycin during a one year period [38]. We conducted a systematic review and meta-analysis of randomized controlled trials that have compared vancomycin and teicoplanin administered systemically for the treatment of suspected or proven infections [39]. We describe a 76-year-old Caucasian Woman with a history of penicillin and sulfa allergies who was transferred to our medical center while receiving vancomycin for treatment of persistent methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia [40].

Five days after discontinuation of vancomycin, the Vasculitis was resolving and continued to resolve throughout the remainder of her hospitalization [41]. Use of the Naranjo adverse drug reaction probability scale indicated that the likelihood of vancomycin being the cause of the Vasculitis was probable (score of 5) [42].

References: 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ,

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