Red man syndrome is caused by which drug:
**Core Concept**
Red man syndrome, also known as red neck syndrome, is a cutaneous adverse reaction characterized by flushing, erythema, and rash, typically occurring after rapid administration of a specific antibiotic. This condition is related to the pharmacokinetics of the drug, particularly its infusion rate and concentration.
**Why the Correct Answer is Right**
Vancomycin-induced red man syndrome is a well-documented side effect of this glycopeptide antibiotic. The condition occurs due to the rapid infusion of vancomycin, leading to a transient but significant release of histamine from mast cells. This histamine release causes vasodilation, increased blood flow to the skin, and subsequent erythema and flushing. The syndrome is typically self-limiting and resolves with slowing of the infusion rate or discontinuation of the drug.
**Why Each Wrong Option is Incorrect**
* **Option A:** Linezolid is an oxazolidinone antibiotic that is less likely to cause red man syndrome due to its different pharmacokinetic profile and mechanism of action. It does not cause significant histamine release or vasodilation.
* **Option B:** Clindamycin is a lincosamide antibiotic that can cause various cutaneous reactions, including rash and erythema, but it is not typically associated with red man syndrome. Its side effect profile is distinct from that of vancomycin.
* **Option D:** Teicoplanin is another glycopeptide antibiotic similar to vancomycin but is less commonly associated with red man syndrome due to its slower infusion rate and different pharmacokinetic properties.
**Clinical Pearl / High-Yield Fact**
When administering vancomycin, it is essential to infuse the drug over a period of at least 60 minutes to minimize the risk of red man syndrome. This can be achieved by using an infusion pump or by dividing the total dose into multiple infusions.
β Correct Answer: C. Vancomycin