万古霉素致早产婴儿红人综合征

1例4月龄支气管肺发育不良早产儿因重症肺炎住院,给予亚胺培南西司他丁钠联合红霉素治疗。住院期间感染加重,停用红霉素,改用盐酸万古霉素60mg溶于5%葡萄糖注射液15ml,以60mg/h的速度静脉滴注。约10-min后,患儿出现哭闹,颜面部潮红;减慢输注速度,患儿仍哭闹,皮肤红斑增多,颈、胸及四肢等处皮肤红斑融合成片,心率增快(160次/min)。考虑为万古霉素导致的红人综合征,立即停药,未行抗过敏治疗。约1 h后皮肤红斑逐渐消退,心率下降至140次/min。次日,患儿皮肤颜色恢复正常。随后根据痰培养药物敏感试验结果改用替考拉宁联合亚胺培南西司他丁钠治疗,患儿未再出现皮疹,2周后肺炎好转出院。

Red man syndrome induced by vancomycin in a premature infant

A 4-month-old premature infant with broncho-pulmonary dysplasia was hospitalized and received imipenem and cilastatin sodium combined with erythromycin for severe pneumonia.During hospitalization,erythromycin was stopped because of exacerbation of infection and replaced by vancomycin hydrochloride 60mg dissolved in 5%glucose injection 15ml by an IV infusion at a speed of 60mg/h.About 10-minutes of vancomycin treatment,the infant developed cry and noisy and facial flushing.Then the infusion speed was slowed down,but the infant was still crying and his skin erythema increased,which gradually fused into pieces on his neck,chest and limbs.And his heart rate increased to 160 beats/min.Red man syndrome induced by vancomycin was considered.Vancomycin was stopped immediately and no antiallergic agents were given.About one hour later,the skin rash disappeared gradually and the heart rate decreased to 140 beats/min.The next day,the skin color returned to normal.Then teicoplanin combined with imipenem and cilastatin sodium were given according to the results of drug sensitivity test in sputum culture.The rash did not recur.Two weeks later,his pneumonia improved and he was discharged.