Infectious Disease Book

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Vancomycin

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  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 (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.
Definition (NCI)A branched tricyclic glycosylated peptide with bactericidal activity against many microorganisms and with bacteriostatic effect for 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.
ConceptsAmino Acid, Peptide, or Protein (T116) , Antibiotic (T195)
EnglishVANCO, Vancomycin, VANCOMYCIN PREPARATION
Spanishvancomicina
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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