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      Síndrome del hombre rojo en pediatría: a propósito de 2 casos Translated title: Syndrome of the red man in pediatrics: a report of 2 cases

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          Abstract

          RESUMEN Describimos dos casos de aparición de síndrome de hombre rojo o cuello rojo (SHR) en población pediátrica, una lactante de 3 meses y un niño de 12 años. En ambos pacientes se sustituyó vancomicina por otro glucopéptido, teicoplanina, sin haberse presentado este síndrome en ninguna de sus administraciones a pesar de la semejanza estructural existente entre ambos fármacos.

          Translated abstract

          Summary We describe two cases of red man or red neck syndrome (RRS) appearance in paediatric population, an infant of 3 months and a child of 12 years. In both patients vancomycin was replaced by another glycopeptide, teicoplanin, without this syndrome having occurred in any of their administrations despite the structural similarity between two drugs.

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          Comparative efficacy and safety of vancomycin versus teicoplanin: systematic review and meta-analysis.

          Shuli Svetitsky, Leonard Leibovici, Mical Paul (2009)
          Vancomycin and teicoplanin are the glycopeptides currently in use for the treatment of infections caused by invasive beta-lactam-resistant gram-positive organisms. We conducted a systematic review and meta-analysis of randomized controlled trials that have compared vancomycin and teicoplanin administered systemically for the treatment of suspected or proven infections. A comprehensive search of trials without year, language, or publication status restrictions was performed. The primary outcome was all-cause mortality. Two reviewers independently extracted the data. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled by using the fixed-effect model (RRs of >1 favor vancomycin). Twenty-four trials were included. All-cause mortality was similar overall (RR, 0.95; 95% CI, 0.74 to 1.21), and there was no significant heterogeneity. In trials that used adequate allocation concealment, the results favored teicoplanin (RR, 0.82; 95% CI, 0.63 to 1.06), while in trials with unknown methods or inadequate concealment, the results favored vancomycin (RR, 3.61; 95% CI, 1.27 to 10.30). The latter trials might have recruited more severely ill patients. No other variable affected the RRs for mortality, including the assessment of glycopeptides administered empirically or for proven infections, neutropenia, the participant's age, and drug dosing. There were no significant differences between teicoplanin and vancomycin with regard to clinical failure (RR, 0.92; 95% CI, 0.81 to 1.05), microbiological failure (RR, 1.24; 95% CI, 0.93 to 1.65), and other efficacy outcomes. Lower RRs (in favor of teicoplanin) for clinical failure were observed with a lower risk of bias and when treatment was initiated for infections caused by gram-positive organisms rather than empirically. Total adverse events (RR, 0.61; 95% CI, 0.50 to 0.74), nephrotoxicity (RR, 0.44; 95% CI, 0.32 to 0.61), and red man syndrome were significantly less frequent with teicoplanin. Teicoplanin is not inferior to vancomycin with regard to efficacy and is associated with a lower adverse event rate than vancomycin.
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            Vancomycin-induced histamine release and "red man syndrome": comparison of 1- and 2-hour infusions.

            D P Healy, J V Sahai, S H Fuller … (1990)
            Vancomycin-induced "red man syndrome" (RMS) is mediated in part by histamine release, and its severity is correlated with the area under the plasma histamine concentration-time curve. Ten adult male volunteers participated in a randomized, double-blind, two-way crossover trial (1-week washout interval between regimens) to determine the effect of 1- and 2-h infusions of vancomycin (1.0 g) on histamine release and on the frequency and severity of RMS. The severity of RMS was classified a priori as mild, moderate, or severe from a combined score of pruritus and extent of erythema. Serial concentrations of histamine in plasma and concentrations of vancomycin in serum were measured at baseline and during and after each infusion. Of 10 subjects, 8 had evidence of RMS during the 1-h infusion (3 mild, 3 moderate, and 2 severe), whereas only 3 of the 10 subjects (all mild) had RMS during the 2-h infusion (P less than 0.05). The 1-h infusion was associated with a significantly greater peak concentration of histamine in plasma (1.8 +/- 0.7 versus 1.0 +/- 0.3 ng/ml, P = 0.004) and a greater total release of histamine (74.3 +/- 54.1 versus 36.4 +/- 22.6 ng.min/ml, P = 0.017) than was the 2-h infusion. These data suggest that administration of vancomycin over 2 h reduces the frequency and severity of RMS and the amount of histamine released compared with those after a 1-h infusion in healthy volunteers.
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              Defining risk factors for red man syndrome in children and adults.

              Angela Myers, Andrea Gaedigk, Hongying Dai … (2012)
              Red man syndrome (RMS) is a well-known adverse reaction that occurs in pediatric patients receiving vancomycin, yet reported prevalence is varied, and characteristics and risk factors are not well understood. Our objective was to determine the prevalence, characteristics and risk factors for RMS in pediatric patients receiving vancomycin, including contributing genetic factors.
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                Author and article information

                Journal
                Journal ID (publisher-id): ofil
                Title: Revista de la OFIL
                Abbreviated Title: Rev. OFIL·ILAPHAR
                Publisher: Organización de Farmacéuticos Ibero-Latinoamericanos (Madrid, Madrid, Spain )
                ISSN (Print): 1131-9429
                ISSN (Electronic): 1699-714X
                Publication date (Print and electronic): 2021
                Volume: 31
                Issue: 2
                Pages: 206-207
                Affiliations
                [1] Madrid orgnameHospital Clínico San Carlos España
                Article
                Publisher ID: S1699-714X2021000200206 Publisher ID: S1699-714X(21)03100200206
                DOI: 10.4321/s1699-714x2021000200017
                SO-VID: 62559094-8b27-492d-9c1c-1c3b92d3bad4
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                Date accepted : 29 August 2019
                Date received : 16 July 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 6, Pages: 2
                Product

                SciELO Spain

                Categories
                Subject: Casos Clínicos

                Keywords: Pediatrics,Pediatría,vancomicina,síndrome hombre rojo,reacción adversa,vancomycin,red man syndrome,adverse drug reaction
                Data availability:
                Keywords: Pediatrics, Pediatría, vancomicina, síndrome hombre rojo, reacción adversa, vancomycin, red man syndrome, adverse drug reaction

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