"RED MAN SYNDROME" WITH VANCOMYCIN.

"Red man syndrome" (RMS) is the most common adverse reaction to vancomycin, characterized by flushing of the upper body, pruritus, hypotension, chest pain, and muscle spasm. Wallace and colleagues prospectively studied 33 patients to learn more about this syndrome.

Before their first vancomycin infusion, the patients were randomized to receive either placebo or 50 mg of oral diphenhydramine. Eight of 17 patients taking placebo, versus 0 of 16 pretreated with diphenhydramine, manifested RMS upon vancomycin infusion. The 8 RMS patients were again randomized to diphenhydramine or placebo before receiving a second infusion of vancomycin. RMS developed in 2 patients pretreated with diphenhydramine and in 1 taking placebo.

All 25 patients with no r…