Infectious Disease Book

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Vancomycin

Aka: Vancomycin
  1. Indications
    1. First Line Agent
      1. Methicillin-resistant Staphylococcus aureus
      2. Staphylococcus epidermidis (non-contaminant)
      3. Bacillus cereus
      4. Corynebacterium jeikeium
      5. Chryseobacterium
    2. Second Line Agent
      1. Clostridium difficile
      2. Enterococcus faecalis
      3. Methicillin-susceptible Staphylococcus aureus
  2. Dosing: Parenteral Vancomycin
    1. Adult: 1 gram IV (given over 1 hour) every 12 hours
    2. Child: 10 mg/kg/dose IV (given over 1 hour) q6 hours
  3. Dosing: Oral Vancomycin for Clostridium difficile
    1. Second-line agent in Pseudomembranous colitis
    2. Adult Dose: 125 mg PO qid for 10 days
    3. Child Dose: 40 mg/kg/day PO divided qid
    4. Newborn Dose: 10 mg/kg/day PO divided qid
  4. Pharmacokinetics: Goal Levels
    1. Peak: 20-50 ug/ml
    2. Trough: 5-10 ug/ml
  5. Precautions
    1. Infuse slowly over 1-2 hours
    2. Indications to Monitor levels
      1. High dose Vancomycin (>2 grams per day)
      2. Renal insufficiency or Renal Failure
  6. Adverse Effects
    1. Excessive Histamine release (rapid infusion)
      1. Angioedema
      2. Flushed skin
      3. Hypotension
    2. Toxicity if co-administered with Aminoglycoside
      1. Ototoxicity
      2. Nephrotoxicity
    3. Neutropenia
    4. Rash
    5. IgA Bullous Dermatosis (rare)
  7. References
    1. Lacy (2000) Drug Information Handbook, Lexi-Comp

Vancomycin (C0042313)

Definition (NCI) A branched tricyclic glycosylated peptide with bactericidal activity against most organisms and bacteriostatic effect on enterococci. At a site different from that of penicillins and cephalosporins, vancomycin binds tightly to the D-alanyl-D-alanine portion of cell wall precursors, thereby interfering with bacterial cell wall synthesis. This leads to activation of bacterial autolysins that destroy the cell wall by lysis. Vancomycin may also alter the permeability of bacterial cytoplasmic membranes and may selectively inhibit RNA synthesis.
Definition (CHV) a kind of antibacterial drug
Definition (MSH) Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to RISTOCETIN that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear.
Definition (CSP) antibacterial obtained from Streptomyces orientalis; a glycopeptide that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear.
Definition (NCI) An antibiotic drug used to fight resistant bacterial infections.
Concepts Amino Acid, Peptide, or Protein (T116) , Antibiotic (T195)
MSH D014640
SnomedCT 372735009, 42082003
English Vancomycin, vancomycin, vancomycin (medication), Vancomycin [Chemical/Ingredient], Vancomycin (product), Vancomycin (substance), VANCO, VANCOMYCIN
Swedish Vankomycin
Czech vankomycin
Finnish Vankomysiini
Russian VANKOMITSIN, ВАНКОМИЦИН
Polish Wankomycyna
Croatian VANKOMICIN
Japanese バンコマイシン, バンコシン
Spanish vancomicina (producto), vancomicina (sustancia), vancomicina, Vancomicina
French Vancomycine
German Vancomycin
Italian Vancomicina
Portuguese Vancomicina
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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