UNDER REVIEW (September 2016)
Mechanism of Action:
A glycopeptide antibiotic with bactericidal activity against aerobic and anaerobic Gram-positive bacteria including multi-resistant staphylococci.
Drug specifics
| Alternative drug name | not specified |
| Effects | Vancomycin is used by the intravenous route in the prophylaxis and treatment of endocarditis and other serious infections caused by Gram-positive cocci. It has a relatively long duration of action and can therefore be given every 12 hours. Vancomycin (added to dialysis fluid) is also used in the treatment of peritonitis associated with peritoneal dialysis [unlicensed route]. Vancomycin given by mouth is effective in the treatment of antibiotic-associated colitis (pseudomembranous colitis) usually as second line agent. Vancomycin should not be given by mouth for systemic infections since it is not significantly absorbed. It may lead to selection of VRE. |
| Adverse actions | The major concern after parenteral administration is nephrotoxicity including renal failure and interstitial nephritis; ototoxicity (discontinue if tinnitus occurs); blood disorders including neutropenia (usually after 1 week or cumulative dose of 25 g), rarely agranulocytosis and thrombocytopenia; many others. |
| Dose | Given IV or orally in the treatment of antibiotic-associated colitis. |
| Interactions | Care should be taken if there is pre-existing renal impairment. |
| Contraindications | not specified |
| Comments | The glycopeptide antibiotics vancomycin and teicoplanin have bactericidal activity against aerobic and anaerobic Gram-positive bacteria including multi-resistant staphylococci. However, there are reports of Staphylococcus aureus with reduced susceptibility to glycopeptides. There are increasing reports of glycopeptide-resistant enterococci (VRE). They act by binding the terminal D-ala-D-ala of the peptidoglycan chain and prevn the incorporation of new sub units to the growing cell wall. Teicoplanin is very similar to vancomycin but has a significantly longer duration of action allowing once-daily administration. Unlike vancomycin, teicoplanin can be given by intramuscular as well as by intravenous injection; it is not given by mouth. |
| Contributors |
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