Red-man syndrome after vancomycin: potential cross-reactivity with teicoplanin

We report a patient with infective endocarditis who developed a severe form of Red-man syndrome after vancomycin. On substituting the antibiotic to te icoplanin, the patient went on to develop a dramatic pyrexia which settled only after the teicoplanin was discontinued. This suggested that there may be an element of crossreactivity between teicoplanin and vancomycin in such patients and that teicoplanin may not be the most appropriate substitute i n all cases of vancomycin-induced Red-man syndrome.