VANCOMYCIN FLUSHING SYNDROME

Course overview

VANCOMYCIN FLUSHING SYNDROME (VFS) WAS PREVIOUSLY KNOWN AS RED MAN SYNDROME (RMS) IS AN ANAPHYLACTOID REACTION CAUSED BY THE RAPID INFUSION OF THE GLYCOPEPTIDE ANTIBIOTIC VANCOMYCIN. VFS CONSISTS OF A PRURITIC, ERYTHEMATOUS RASH OF THE FACE, NECK, AND UPPER TORSO, WHICH MAY ALSO INVOLVE THE EXTREMITIES, THOUGH TO A LESSER DEGREE. SYMPTOMS MAY INCLUDE WEAKNESS, ANGIOEDEMA, AND CHEST OR BACK PAIN. VFS IS CAUSED BY VANCOMYCIN THROUGH THE DIRECT AND NON-IMMUNE-MEDIATED RELEASE OF HISTAMINE FROM MAST CELLS AND BASOPHILS. THE AMOUNT OF HISTAMINE RELEASE IS GENERALLY RELATED TO THE DOSAGE OF VANCOMYCIN INFUSED AND THE RATE OF INFUSION. VFS IS GENERALLY ASSOCIATED WITH MORE RAPID INFUSION RATES BUT CAN BE SEEN FOLLOWING SLOWER INFUSION RATES AND AFTER SEVERAL DAYS OF TRANSFUSION. PRACTITIONERS USING VANCOMYCIN SHOULD BE AWARE OF THIS DRUG REACTION, ITS PREVENTION, AND TREATMENT. THIS ACTIVITY DESCRIBES THE EVALUATION, DIAGNOSIS, AND MANAGEMENT OF VANCOMYCIN FLUSHING SYNDROME AND STRESSES THE ROLE OF TEAM-BASED INTERPROFESSIONAL CARE FOR AFFECTED PATIENTS.