Vancomycin anaphylaxis and successful desensitization.

This report describes vancomycin anaphylaxis and successful desensitization. A 35-year-old woman who tolerated vancomycin initially, developed generalized urticaria and respiratory distress when the drug was readministered. Symptoms recurred following infusion of vancomycin at a lowered rate and dose despite premedication with antihistamines and corticosteroids. Intradermal skin tests with vancomycin were positive at a concentration of 0.1 μg/mL. Control subjects reacted at a concentration of 10 μg/mL or greater. A rapid 1-day desensitization protocol was unsuccessful. The patient then was «desensitized» by sequential increments in intravenous vancomycin doses over 13 days