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Vancomycin Ototoxicity in Dialysis — SCE Infectious Diseases MCQ

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HardAntimicrobial StewardshipVancomycin Ototoxicity in DialysisSCE Infectious Diseases

During vancomycin infusion a patient develops flushing and pruritus of the upper body without wheeze, angioedema or hypotension. What is the best interpretation and response?

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Correct answer: A — Rate-related vancomycin infusion reaction: stop temporarily, treat symptoms and restart more slowly if appropriate

The best answer is “Rate-related vancomycin infusion reaction: stop temporarily, treat symptoms and restart more slowly if appropriate”. Flushing and upper-body pruritus during vancomycin infusion without wheeze, angioedema or hypotension is a rate-related infusion reaction, not IgE anaphylaxis. Stop the infusion temporarily, treat symptoms and restart more slowly if appropriate. It does not indicate antimicrobial failure, ototoxicity or acute renal failure.

Reference: Vancomycin SmPC: https://www.medicines.org.uk/emc/product/8759/smpc