Red man syndrome caused by oral vancomycin
10.3760/cma.j.cn114015-20201105-01108
- VernacularTitle:口服万古霉素致红人综合征
- Author:
Jingjing LUO
1
;
Xin′an WU
;
Gang XUE
;
Jiahua LI
;
Chengting RONG
Author Information
1. 合肥京东方医院药学科，合肥 230011
- Publication Type:Journal Article
- Keywords:
Vancomycin;
Administration, oral;
Erythema
- From:
Adverse Drug Reactions Journal
2021;23(4):221-223
- CountryChina
- Language:Chinese
-
Abstract:
A 55-year-old male patient had received a variety of antibiotics including vancomycin for injection for sepsis and pulmonary infection after the trauma surgery for multiple fractures due to a traffic accident, which caused antibiotic-associated diarrhea and bullous rash. But the exact allergenic drug was unknown. After the infection was improved, the above antibiotics were discontinued and loratadine 10 mg orally once daily was given, and the rash gradually subsided. The patient had another pulmonary infection during trauma recovery period and was given an IV infusion of cefoperazone sodium and sulbactam sodium 3 g once per 12 hours. After the treatment, the patient′s antibiotic-associated diarrhea worsened, then cefoperazone sodium and sulbactam sodium was discontinued, and vancomycin 0.5 g orally once per 6 hours was given. About 1 hour after the 4th dose of oral vancomycin, the patient developed skin erythema on the neck, which quickly spread to the upper chest, without fever or itching. Red man syndrome caused by oral vancomycin was considered after a dermatologist consultation. Vancomycin was discontinued, an intravenous injection of dexamethasone 5 mg and an intramuscular injection promethazine 25 mg were given, and loratadine was continued. The erythema began to subside and the diarrhea occurred less after 4 days of drug withdrawal. After 7 days of drug withdrawal, the patient′s diarrhea was improved and her skin erythema largely subsided.
