Vancomycin Flushing Syndrome

Excerpt

Vancomycin flushing syndrome (VFS) is an anaphylactoid reaction caused by the rapid infusion of the glycopeptide antibiotic vancomycin. VFS consists of a pruritic, erythematous rash to the face, neck, and upper torso, which may also involve the extremities 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 histamine release from mast cells and basophils. The amount of histamine released is generally related to the dose of vancomycin infused and the infusion rate. 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 know this reaction, its prevention, and treatment.