VANCOMYCIN AND CARDIAC-ARREST IN THE INFA NT

Background, - Different adverse effects induced by vancomycin bolus in fusion are described, but cardiac arrest seems rare, in children as in adults. Case report - Two infants, 5 and 12 months old were admitted after cardiac arrest, following vancomycin bolus infusion in excessive dose. They recovered after prompt resuscitation and their short term follow-up was normal. Conclusion. - Two mechanisms are invoked: anaphy lactic shock and direct cardiovascular toxicity. Both are dose- and in fusion rare-dependent; and probably intersubject dependent. Usually, c ardiac arrest is promptly reversed by adequate resuscitation. The rule s of prescription are: adequate dilution and slow rate of infusion. If any adverse effect occurred, preventive antihistaminic drug therapy s hould be advised. (C) 1998, Elsevier, Paris.