Vancomycin
Bacterial Endocarditis, Pseudomembranous Enterocolitis ... show more
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DRUG STATUS
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
YES
Known Teratogen
No
Pharmaceutical Class
Glycopeptide Antibacterial
Controlled Drug Substance
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Vancomycin
Learn more about this medicine -
Click HereSummary
Vancomycin is used to treat serious bacterial infections such as methicillin-resistant Staphylococcus aureus (MRSA) and Clostridioides difficile. It is particularly effective for conditions like pneumonia, bone infections, and bloodstream infections, especially when other antibiotics are ineffective.
Vancomycin works by stopping bacteria from multiplying and leading to their death. It does this by inhibiting bacterial cell wall synthesis. It is particularly effective against Gram-positive bacteria, including resistant strains.
For adults, IV vancomycin is typically 15-20 mg/kg every 8-12 hours. For C. difficile infections, the oral dose is 125-500 mg every 6 hours. Dosages for children vary based on weight.
Common side effects include nausea, rash, flushing, and kidney damage. Serious side effects can include hearing loss, allergic reactions, and low white blood cell counts.
People with severe kidney disease, hearing impairment, or known allergies to vancomycin should avoid it. Elderly patients and those taking nephrotoxic drugs need to be cautious as they are at higher risk of kidney damage.
Indications and Purpose
What is Vancomycin used for?
Vancomycin treats severe bacterial infections, including MRSA, pneumonia, osteomyelitis, septicemia, endocarditis, and C. difficile-associated diarrhea. It is used when other antibiotics are ineffective or if the bacteria are resistant. Due to its potency, it is usually reserved for serious infections in hospitalized patients.
How does Vancomycin work?
Vancomycin inhibits bacterial cell wall synthesis, preventing bacteria from multiplying and leading to their death. It is particularly effective against Gram-positive bacteria, including resistant strains. Since it does not work on Gram-negative bacteria, its use is limited to specific infections.
Is Vancomycin effective?
Yes, vancomycin is highly effective for resistant bacterial infections, especially MRSA and C. difficile. Studies show a high cure rate when used properly. However, vancomycin-resistant bacteria (VRE) have emerged, making proper dosing and monitoring crucial to prevent resistance and ensure effectiveness.
How does one know if Vancomycin is working?
Improvement is seen when fever, pain, and infection-related symptoms decrease. For IV vancomycin, blood tests and cultures are used to confirm bacterial elimination. In C. difficile infections, reduced diarrhea and stomach pain indicate effectiveness. If symptoms persist, a doctor may adjust the dose or treatment.
Directions for Use
What is the usual dose of Vancomycin?
The dose depends on the infection type, severity, kidney function, and body weight. For adults, IV vancomycin is typically 15-20 mg/kg every 8–12 hours. For C. difficile infections, the oral dose is 125–500 mg every 6 hours. Pediatric doses vary based on weight and are carefully monitored to prevent toxicity.
How do I take Vancomycin?
Vancomycin is usually given intravenously (IV) for systemic infections and orally for intestinal infections like C. difficile colitis. The IV infusion should be administered slowly over 60 minutes or more to avoid infusion reactions. Oral vancomycin can be taken with or without food, but consistency in administration times is essential for effectiveness.
For how long do I take Vancomycin?
Treatment duration varies depending on the infection type and severity. For MRSA infections, treatment may last 1 to 6 weeks. For C. difficile infections, the oral course is usually 10 to 14 days. Always complete the prescribed course to prevent bacterial resistance and relapse.
How long does it take for Vancomycin to start working?
Vancomycin begins working within a few hours of administration, but noticeable improvement usually takes 24 to 48 hours. For severe infections, it may take several days to see full recovery. Blood levels are monitored to ensure therapeutic effectiveness and avoid toxicity.
How should I store Vancomycin?
Store vancomycin tablets or oral solution at room temperature (15–30°C), away from heat, moisture, and direct sunlight. IV formulations should be refrigerated and used within 24 hours of mixing. Keep out of reach of children.
Warnings and Precautions
Who should avoid taking Vancomycin?
People with severe kidney disease, hearing impairment, or known allergies to vancomycin should avoid it. Caution is needed in elderly patients and those taking nephrotoxic drugs, as they are at higher risk of kidney damage.
Can I take Vancomycin with other prescription drugs?
Vancomycin interacts with aminoglycosides (gentamicin, tobramycin), NSAIDs, and loop diuretics (furosemide), increasing the risk of kidney and hearing damage. It may also enhance the effects of neuromuscular blockers. Drug level monitoring is essential when combining it with other medications.
Can I take Vancomycin with vitamins or supplements?
Yes, but be cautious with calcium, magnesium, and iron supplements, as they may interfere with absorption. Patients should also avoid herbal supplements that affect kidney function, such as St. John’s Wort or high-dose vitamin C. Always consult a doctor before combining supplements with vancomycin.
Can Vancomycin be taken safely while pregnant?
Vancomycin is considered safe in pregnancy when used for serious infections, but only if necessary. It does not appear to cause birth defects, but monitoring is required to avoid kidney and hearing damage in the baby. IV vancomycin should be used with caution and under medical supervision.
Can Vancomycin be taken safely while breastfeeding?
Yes, vancomycin is excreted in small amounts in breast milk, but it is unlikely to harm the infant. However, monitoring for diarrhea, rashes, or unusual fussiness in the baby is advised. If any issues arise, consult a doctor before continuing.
Is Vancomycin safe for the elderly?
Elderly patients are more susceptible to kidney and hearing damage from vancomycin. Dosage adjustments and regular kidney function monitoring are required to minimize risks. Lower doses may be used if kidney function is impaired.
Is it safe to exercise while taking Vancomycin?
Mild to moderate exercise is usually safe while taking vancomycin, but intense physical activity should be avoided if experiencing weakness, dizziness, or fatigue. Staying hydrated and monitoring kidney function is essential, especially during prolonged treatment.
Is it safe to drink alcohol while taking Vancomycin?
Alcohol should be avoided while taking vancomycin, as it can increase the risk of liver and kidney damage, worsen dizziness, and reduce the body’s ability to fight infection. If drinking is necessary, it should be in moderation and only after consulting a doctor.
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