Which drug can cause Red Man Syndrome, and when does this occur?

Which drug can cause Red Man Syndrome, and when does this occur?

• A. Vancomycin infused above 1 g/hr
• B. Meropenem infused over 1 g/hr
• C. Cefazolin infused over 2 g/hr
• D. Linezolid infused over 600 mg/hr

Answer: (A)

Red Man Syndrome is an infusion-related reaction caused by vancomycin. It happens when vancomycin is given IV too quickly, triggering non-IgE–mediated histamine release from mast cells. The result is flushing and erythema of the upper body and face, sometimes with itching and even low blood pressure. The risk rises with rapid infusion, typically described as infusing more than about 1 g per hour. The best prevention is to slow the infusion to allow at least 1 hour per gram (or longer), and if needed, treat symptoms with an antihistamine. This reaction is specific to vancomycin and is not a true drug allergy. The other antibiotics listed do not characteristically cause Red Man Syndrome.

Red Man Syndrome is an infusion-related reaction caused by vancomycin. It happens when vancomycin is given IV too quickly, triggering non-IgE–mediated histamine release from mast cells. The result is flushing and erythema of the upper body and face, sometimes with itching and even low blood pressure. The risk rises with rapid infusion, typically described as infusing more than about 1 g per hour. The best prevention is to slow the infusion to allow at least 1 hour per gram (or longer), and if needed, treat symptoms with an antihistamine. This reaction is specific to vancomycin and is not a true drug allergy. The other antibiotics listed do not characteristically cause Red Man Syndrome.