Some patients experience flushing, neck redness and dyspnea during vancomycin infusion, what is going on? Let’s take a look. Vancomycin belongs to the glycopeptide class of antibacterial drugs and is indicated for serious infections caused by methicillin-resistant Staphylococcus aureus. Its adverse reactions include allergic reactions, liver damage, otolaryngotoxicity, etc. However, if vancomycin is infused rapidly or intravenously for a short period of time, erythrocytic syndrome may occur, often manifesting as erythematous congestion of the face and neck trunk, and in severe cases, hypotension, respiratory distress, and cardiac arrest may also occur. The earliest report of erythrocyte syndrome occurred in 1959, and its occurrence is not through the immune response, but directly causes mast cell degranulation and release of histamine, which is a non-immune, histamine-mediated hypersensitivity reaction. Vancomycin-induced erythrocytic syndrome is gender-independent and occurs most often in children and people over 50 years of age. When applying vancomycin, care should be taken: (1) Patients and family members should be aware of this reaction and report it to the health care provider as soon as it is detected. (2) Patients with abnormal renal function should be more careful. (3) Control the concentration of the drug by adding each gram of the drug to at least 200 ml of fluid for intravenous infusion. (4) Control the drip rate and drip for at least 60 minutes. (5) If there is a history of drug allergy, H1 receptor blockers (such as Benadryl) can be given prophylactically. (6) Once the red man syndrome occurs, vancomycin should be discontinued immediately, along with anti-inflammatory and other symptomatic treatment until the symptoms disappear. (7) If the infection has been controlled, the drug should be discontinued promptly.