VANCOMYCIN ANAPHYLAXIS AND SUCCESSFUL DESENSITIZATION

This report describes vancomycin anaphylaxis and successful desensitiz ation. A 35-year-old woman who tolerated vancomycin initially, develop ed generalized urticaria and respiratory distress when the drug was re administered. Symptoms recurred following infusion of vancomycin at a lowered rate and dose despite premedication with antihistamines and co rticosteroids. Intradermal skin tests with vancomycin were positive at a concentration of 0.1 mu g/mL. Control subjects reacted at a concent ration of to mu g/mL or greater. A rapid 1-day desensitization protoco l was unsuccessful. The patient then was ''desensitized'' by sequentia l increments in intravenous vancomycin,cin doses over 13 days. After t he full therapeutic dose was tolerated, there was a loss of skin test reactivity to vancomycin. We conclude that desensitization to vancomyc in is possible and may be the only means to treat an allergic patient adequately when there are no viable therapeutic alternatives.