Abstract
To the Editor.— Gram-positive organisms such as coagulase-negative staphylococci, enterococci, CDC-JK diphtheroids, and Bacillus species have emerged as important nosocomial pathogens in patients with neutropenic cancer and cause 20% to 30% of all bacterial infections seen at our institution. These organisms are frequently multidrug resistant and have resulted in an increase in the use of vancomycin hydrochloride as initial empiric antibiotic therapy in this group of patients. 1 The administration of intravenous vancomycin hydrochloride has been associated with the development of hypotension and a maculopapular rash that often involves the face, neck, trunk, and upper extremities. This is most often associated with the rapid administration of vancomycin, although it has been described after slow infusion as well. This has been commonly referred to as the red man's syndrome or the red neck syndrome. 2,3 Having had the opportunity to observe several instances of this over the past
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