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BACKGROUND Different adverse effects induced by vancomycin bolus infusion are described, but cardiac arrest seems rare, in children as in adults. METHODS Two infants, 5 and 12 months old, were admitted after cardiac arrest, following vancomycin bolus infusion in excessive dose. They recovered after prompt resuscitation and their short term follow-up was normal. CONCLUSIONS Two mechanisms are invoked: anaphylactic shock and direct cardiovascular toxicity. Both are dose- and infusion rate-dependent, and probably intersubject dependent. Usually, cardiac arrest is promptly reversed by adequate resuscitation. The rules of prescription are: adequate dilution and slow rate of infusion. If any adverse effect occurred, preventive antihistaminic drug therapy should be advised.
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