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A 56-year-old man is hospitalized with an
infection for which intravenous antibiotics are required. Upon questioning,
it is revealed that he has a penicillin allergy. Which of the following
statements regarding the choice of antibiotics in this situation is
correct?
A 68-year-old woman has been hospitalized for
three days after an exacerbation of emphysema. Her clinical course
progresses well until the fourth hospital day, when she develops shortness
of breath, fatigue, and cough productive of yellow sputum. Her oxygen
saturation drops by 10%, and she is started on vancomycin and gentamicin via
rapid infusion. Thirty minutes after the initiation of antibiotics, the
patient develops erythema of the face and neck, itchiness, and hypotension.
The patient has no known drug allergies and has not been treated with
vancomycin prior to this hospitalization. Which of the following is the
mechanism of this reaction?
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