From Wikipedia, the free encyclopedia Vancomycin is an antibiotic medication used to treat a number of bacterial infections. It is recommended intravenously as a treatment for complicated skin infections, bloodstream infections, endocarditis, bone and joint infections, and meningitis caused by methicillin-resistant Staphylococcus aureus.
- AU: B2
- Excreted unchanged
- Vancocin, others
VANCOmycin is mainly used for patients with Cystic Fibrosis and is commonly used as the first and foremost the antibiotic used to treat exacerbations.
Vancomycin-intermediate S. aureus (VISA) (/ ˈviːsə / or / viːaɪɛseɪ /) was first identified in Japan in 1996 and has since been found in hospitals elsewhere in Asia, as well as in the United Kingdom, France, the U.S., and Brazil.
- Disk diffusion
- Beta-lactam antibiotic (in combination)
- Mechanism of acquired resistance
- Treatment of infection
Vancomycin-resistant Enterococcus, or vancomycin-resistant enterococci, are bacterial strains of the genus Enterococcus that are resistant to the antibiotic vancomycin.
Six different types of vancomycin resistance are shown by enterococcus: Van-A, Van-B, Van-C, Van-D, Van-E and Van-G. The significance is that Van-A VRE is resistant to both vancomycin and teicoplanin, Van-B VRE is resistant to vancomycin but susceptible to teicoplanin, and Van-C is only partly resistant to vancomycin.
Once the individual has VRE, it is important to ascertain which strain.
Screening for VRE can be accomplished in a number of ways. For inoculating peri-rectal/anal swabs or stool specimens directly, one method uses bile esculin azide agar plates containing 6 μg/ml of vancomycin. Black colonies should be identified as an enterococcus to species level and further confirmed as vancomycin resistant by an MIC method before reporting as VRE. Vancomycin resistance can be determined for enterococcal colonies available in pure culture by inoculating a suspension of the ...
Ceftriaxone use is a risk factor for colonization and infection by VRE, and restriction of cephalosporin usage has been associated with decreased VRE infection and transmission in hospitals. Lactobacillus rhamnosus GG, a strain of L. rhamnosus, was used successfully for the first time to treat gastrointestinal carriage of VRE. In the US, linezolid is commonly used to treat VRE.
To become vancomycin-resistant, vancomycin-sensitive enterococci typically obtain new DNA in the form of plasmids or transposons which encode genes that confer vancomycin resistance. This acquired vancomycin resistance is distinguished from the natural vancomycin resistance of certain enterococcal species including E. gallinarum and E. casseliflavus/flavescens. High-level vancomycin-resistant E. faecalis and E. faecium are clinical isolates first documented in the 1980s. In the United States, va
- Vancomycin-resistant enterococci
- Screen with peri-rectal swab
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Glycopeptide antibiotics are a class of drugs of microbial origin that are composed of glycosylated cyclic or polycyclic nonribosomal peptides. Significant glycopeptide antibiotics include the anti-infective antibiotics vancomycin, teicoplanin, telavancin, ramoplanin and decaplanin, corbomycin, complestatin and the antitumor antibiotic bleomycin. Vancomycin is used if infection with methicillin-resistant Staphylococcus aureus is suspected.
Some members of this class of drugs inhibit the synthesis of cell walls in susceptible microbes by inhibiting peptidoglycan synthesis. They bind to the amino acids within the cell wall preventing the addition of new units to the peptidoglycan. In particular, they bind to acyl-D-alanyl-D-alanine in peptidoglycan. Many glycopeptides inhibit the function of glycosyltransferases, which polymerase amino acid/sugar building blocks into peptidoglycan.
Due to their toxicity, use of glycopeptide antibiotics is restricted to patients who are critically ill, who have a demonstrated hypersensitivity to the β-lactams, or who are infected with β-lactam-resistant species. These antibiotics are effective principally against Gram-positive cocci. They exhibit a narrow spectrum of action, and are bactericidal only against the enterococci. Some tissues are not penetrated very well by glycopeptides, and they do not penetrate into the cerebrospinal fluid.
Vancomycin was isolated in 1953 and used clinically by 1958, while teicoplanin was discovered in 1978 and became clinically-available in 1984. Telavancin is a semi-synthetic lipoglycopeptide derivative of vancomycin approved by FDA in 2009. Teicoplanin has historically been more widely-marketed - and thus more used - in Europe compared to the U.S. It has more fatty acid chains than vancomycin and is considered to be 50 to 100 times more lipophillic. Teicoplanin also has an increased half-life co
Several derivatives of vancomycin are currently being developed, including oritavancin and dalbavancin. Possessing longer half-lives than vancomycin, these newer candidates may demonstrate improvements over vancomycin due to less frequent dosing and activity against vancomycin-resistant bacteria.
Vancomycin is usually given intravenously, as an infusion, and can cause tissue necrosis and phlebitis at the injection site if given too rapidly. Pain at site of injection is indeed a common adverse event. One of the side-effects is red man syndrome, an idiosyncratic reaction to bolus caused by histamine release. Some other side-effects of vancomycin are nephrotoxicity including kidney failure and interstitial nephritis, blood disorders including neutropenia, and deafness, which is reversible o
Type: GlycopeptidesDosage Forms:Common Trade Names: Vancocin
- Adult Dosing
- Special Populations
- Adverse Reactions
- Antibiotic Sensitivities
1. 15-20mg/kg IV loading dose 2. Sample Loading Dose Table (individual ED guidelines may differ) 2.1. >40kg:750mg IV 2.2. 40-59kg:1000mg IV 2.3. 60-90kg:1500mg IV 2.4. >90kg:2000mg IV 3. Alternative loading dose for serious infections: 20-25mg/kg IV 4. Loading doses of 30mg/kg has shown improved target trough levels at 12 hrs with no difference in nephrotoxicity 5. Adjust maintenance dose based on serum levels
All: Adjust repeat doses based on serum levels 1. <50kg:500mg IV q12h 2. 50-69kg:750mg IV q12h 3. >70kg:1000mg IV q12h 4. Alternative (All Weights): 10-15mg/kg IV q12 5. Adjust dose based on serum levels
1. 1st occurrence 1.1. Uncomplicated: 125mg PO q6h x 10-14 days 1.2. Complicated: 500mg PO/NG q6h 1.2.1. May use in combo with metronidazoleIV 1.2.2. Consider adding vancomycin 500mg PR q6 if complete ileus 2. 2nd occurrence 2.1. Uncomplicated: 125mg PO q6h x 10-14 days 2.2. Complicated: 500mg PO/NG q6h 2.2.1. May use in combo with metronidazoleIV 2.2.2. Consider adding vancomycin 500mg PR q6 if complete ileus 3. 3rd+ occurrence 3.1. 125mg PO q6h x 10-14 days, then daily x 7 days, then q2-3 d...Lactation: Probably safeRenal DosingHepatic Dosing (Adult & Pediatric)
1. Anaphylaxis 2. Severe hypotension (rapid IV use) - not much evidence but consider anti-histamine: 2.1. 1.25-1.67mg/kg/dose diphenhydramineIV to pediatric patients 2.2. 25 - 50mg diphenhydramineIV to adults 3. Thrombophlebitis 4. Tissue necrosis (if extravasation) 5. vasculitis 6. Exfoliative dermatitis 7. Stevens-Johnson Syndrome 8. Toxic Epidermal Necrolysis 9. Drug rash with eosinophilia and systemic symptoms 10. Interstitial nephritis 11. Nephrotoxicity 12. Ototoxicity 13. Neutropenia 1...
1. Red Man Syndrome (rapid IV use) 2. Hypotension(rapid IV use) 3. Fever 4. Nausea 5. rigors 6. Eosinophilia 7. Rash 8. Urticaria 9. Phlebitis 10. Tinnitus 11. Dizziness/Vertigo 12. Elevated BUN/Creatinine 13. Vomiting(PO use) 14. Flatulence (PO use)Half-life: 4-6h (7.5 days ESRD)Metabolism: CYP450Excretion:Mechanism of Action
1. Ssusceptible/sensitive (usually) 2. Iintermediate (variably susceptible/resistant) 3. Rresistant (or not effective clinically) 4. S+synergistic with cell wall antibiotics 5. Usensitive for UTI only (non systemic infection) 6. X1no data 7. X2active in vitro, but not used clinically 8. X3active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis 9. X4active in vitro, but not clinically effective for strep pneumonia
Vancomycin is a complex glycopeptide from Streptomyces orientalis. It inhibits a specific step in the synthesis of the peptidoglycan layer in the Gram-positive bacteria Staphylococcus aureus and Clostridium difficile. It has a role as an antimicrobial agent, an antibacterial drug and a bacterial metabolite.
Nov 09, 2020 · Vancomycin is an antibiotic. Oral (taken by mouth) vancomycin fights bacteria in the intestines. Vancomycin is used to treat an infection of the intestines caused by Clostridium difficile, which can cause watery or bloody diarrhea. This medicine is also used to treat staph infections that can cause inflammation of the colon and small intestines.
- Vancocin HCl Pulvules
- Glycopeptide antibiotic
vancomycin. Wikipedia. Medical Information Search. If oral vancomycin was used for the initial episode, then a prolonged oral vancomycin pulse dose of 125 mg four times daily for ...