Abstract

Vancomycin is the antibiotic of first choice for the treatment of methicillin resistantStaphylococcus aureus (MRSA) infection. Its use is associated with adverse effects in children with a frequency of 5 -14% and in adults with 1.6 - 35%. Of these adverse effects to vancomycin, two kinds have been described. The first is anaphylactic immunologic or immediate hypersensitivity mediated by immunoglobulin type E (IgE). The second is IgE independent anaphylactoid reaction, also referred to as nonallergic drug hypersensitivities or pseudoallergic reactions, known as red man syndrome (RMS). The signs and symptoms of anaphylactoid reaction principally occur in the first dose of vancomycin and could be accompanied by hypotension and cardiac arrest. The severity of the reaction is proportional to the dose administered, infusion velocity, and liberation of histamine in blood.

Key words: Vancomycin, adverse effects, hypersensitivity, red man syndrome, histamine, infant population.