Infectious Disease Book

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Vancomycin

Aka: Vancomycin, Telavancin, Vibativ, Dalbavancin, Dalvance, Oritavancin, Orbactiv
  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. Preparations
    1. Standard agents
      1. Vancomycin
      2. Telavancin (Vibativ)
    2. Longer acting agents (released around 2014)
      1. Dalbavancin (Dalvance)
        1. Infused over 30 minutes weekly
      2. Oritavancin (Orbactiv)
        1. Infused over 3 hours
        2. Single dose may be sufficient for MRSA Cellulitis
    3. References
      1. (2014) Presc Lett 21(8): 43
  3. Dosing: Parenteral Vancomycin
    1. Child
      1. Dose: 10 mg/kg/dose IV (over 1-2 hours) q6 hours
    2. Adult
      1. Dose: 15-20 mg/kg IV every 12 hours
      2. Precaution: 1 gram IV (over 1-2 hours) every 12 hours is only the dose for a 70 kg patient (but will be inadequate for a heavier patient)
      3. Consider dosing in 250 mg increments
  4. 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
  5. Pharmacokinetics: Goal Levels
    1. Peak: 20-50 ug/ml
    2. Trough: 5-10 ug/ml
  6. 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
    3. Vancomycin is a large molecule that crosses the blood-brain barrier
  7. 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)
  8. References
    1. Lacy (2000) Drug Information Handbook, Lexi-Comp
Medication Costs
vancomycin (on 8/17/2016 at Medicaid.Gov Pharmacy Drug pricing)
VANCOMYCIN 1 GM VIAL Generic $13.24 each
VANCOMYCIN 500 MG VIAL Generic $6.50 each
VANCOMYCIN HCL 125 MG CAPSULE Generic $7.05 each
VANCOMYCIN HCL 250 MG CAPSULE Generic $10.32 each
VANCOMYCIN HCL 5 GM VIAL Generic $29.51 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Vancomycin (C0042313)

Definition (CHV) a kind of antibacterial drug
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 (NCI_NCI-GLOSS) An antibiotic drug used to fight resistant bacterial infections.
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.
Concepts Antibiotic (T195) , Amino Acid, Peptide, or Protein (T116)
MSH D014640
SnomedCT 372735009, 42082003
LNC LP16306-0, MTHU004271
English Vancomycin, vancomycin (medication), Vancomycin [Chemical/Ingredient], vancomycin, VANCOMYCIN, Vancomycin (product), Vancomycin (substance), VANCO
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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