Editing Vancomycin (section)

====Vancomycin Flushing Reaction (aka "Red man syndrome")====
{{see also|Erythroderma}}
Vancomycin is recommended to be administered in a dilute solution slowly, over at least 60 min (maximum rate of 10&nbsp;mg/min for doses >500&nbsp;mg)<ref name="AMH2006" /> due to the high incidence of pain and thrombophlebitis and to avoid an infusion reaction known as vancomycin flushing reaction. This phenomenon has been often clinically referred to as "red man syndrome". The reaction usually appears within 4 to 10&nbsp;min after the commencement or soon after the completion of an infusion and is characterized by flushing and/or an [[erythematous]] rash that affects the face, neck, and upper torso, attributed to the release of histamine from mast cells. This reaction is caused by the interaction of vancomycin with [[MRGPRX2]], a GPCR-mediating IgE-independent mast cell degranulation.<ref name="pmid28367504">{{cite journal | vauthors = Azimi E, Reddy VB, Lerner EA | title = Brief communication: MRGPRX2, atopic dermatitis and red man syndrome | journal = Itch | volume = 2 | issue = 1 | pages = e5 | date = March 2017 | pmid = 28367504 | pmc = 5375112 | doi = 10.1097/itx.0000000000000005 }}</ref> Less frequently, [[hypotension]] and [[angioedema]] occur. Symptoms may be treated or prevented with [[antihistamine]]s, including [[diphenhydramine]], and are less likely to occur with slow infusion.<ref name="Sivagnanam2003">{{cite journal | vauthors = Sivagnanam S, Deleu D | title = Red man syndrome | journal = Critical Care | volume = 7 | issue = 2 | pages = 119–20 | date = April 2003 | pmid = 12720556 | pmc = 270616 | doi = 10.1186/cc1871 | doi-access = free }}</ref><ref name="Andrews">{{cite book | vauthors = James W, Berger T, Elston D | date = 2005 | title = Andrews' Diseases of the Skin: Clinical Dermatology | edition = 10th |pages=120–1| publisher = Saunders | isbn = 0-7216-2921-0 }}</ref>