Vancomycin Immediate Skin Responses In Vancomycin-Naive Subjects

The increasing prevalence of Methicillin-resistant Staphylococcus aureus over the last two decades has led to increased vancomycin use and vancomycin-associated infusion reactions. Immediate IgE-independent hypersensitivity reactions (HSRs) to vancomycin, known as "Red Man Syndrome," are commonly seen in clinical practice and, in the majority of cases, avoided by slowing the infusion and/or premedication with antihistamines [1]. Conversely, IgE-dependent HSRs to vancomycin are rare, only described in case reports, and vancomycin-specific IgE measurement has not been reported in the literature [2, 3]. In some cases, the two types of immediate HSRs are indistinguishable, and patients are assumed to have an IgE-mediated HSR resulting in vancomycin avoidance even when needed [4].