Vancomycin
Also known as: Firvanq, Lyphocin, VAN, Vancocin, Vancocin HCl, Vancoled, Vancomycin hydrochloride
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Summary
Vancomycin is a clinically approved glycopeptide used intravenously for serious Gram‑positive infections (e.g., MRSA, enterococcal infections) and orally for Clostridioides difficile colitis.
Mechanism of Action
Binds the D-Ala-D-Ala terminus of peptidoglycan precursors, blocking transglycosylation and transpeptidation and thereby inhibiting bacterial cell‑wall synthesis
Routes of Administration
Goals & Uses
- Treatment of enterococcal infectionsAntimicrobial TherapyHigh
- Surgical prophylaxis in beta-lactam allergic patientsProphylaxisModerate
- Treatment of C. difficile colitisInfectionHigh
- Treatment of MRSA infectionsAntimicrobialHigh
- Prophylaxis in neutropenic patientsPreventionModerate
- Treatment of Clostridioides difficile colitisAntimicrobial TherapyHigh
- Treatment of CNS infections (meningitis)Antimicrobial TherapyModerate
Contraindications
- Severe pre-existing hearing lossOtotoxicity RiskModerate
- Known hypersensitivity to vancomycinAllergyHigh
- Hypersensitivity to vancomycinAllergyHigh
- Severe renal impairment with no dose adjustmentRenalModerate
- Vancomycin-resistant organisms (VRE)Microbial ResistanceHigh
Adverse Effects
- ThrombophlebitisVascularCommon
- ThrombocytopeniaHematologicRareLow platelet count
- OtotoxicityAuditory/vestibularUncommon
- HypotensionCardiovascularUncommonLow blood pressure
- Red‑man syndromeInfusion‑relatedCommon
- Red man syndromeInfusion ReactionCommon
- NeutropeniaHematologicUncommonLow neutrophil count
- NephrotoxicityRenalCommon
Drug Interactions
- AminoglycosidesHigh
- Neuromuscular blocking agentsModerate
- Aminoglycosides (e.g., gentamicin, tobramycin)High
- Piperacillin-tazobactamModerate
- NSAIDsModerateMay increase renal risk in susceptible patients
- NSAIDs (e.g., indomethacin)Moderate
- Loop diuretics (e.g., furosemide)Moderate
Population Constraints
- Pregnancy (Category C/B2)PregnancyRelative
- Renal impairmentOrgan ImpairmentRelative
- ElderlyAgeRelative
- Elderly patientsAgeRelative
- Neonates and premature infantsPediatricRelative
- Pregnant womenReproductiveRelative
- NeonatesPediatricRelative
- Hearing-impaired patientsPre Existing ConditionRelative
Regulatory Status
- European UnionApprovedApproved: Serious Gram‑positive infections, C. difficile colitis (oral)Similar to US
- United StatesApprovedApproved: Complicated skin and skin‑structure infections, Bacteremia, Endocarditis, Osteomyelitis, C. difficile colitis (oral)IV and oral formulations
- United KingdomApprovedApproved: Severe Gram‑positive infections, C. difficile colitis
Therapeutic drug monitoring recommended for IV use; monitor renal function and hearing; red‑man syndrome can occur with rapid infusion.
Evidence & Sources
No sources recorded yet.
Frequently Asked Questions
What is Vancomycin?
Vancomycin is a clinically approved glycopeptide used intravenously for serious Gram‑positive infections (e.g., MRSA, enterococcal infections) and orally for Clostridioides difficile colitis.
What is Vancomycin used for?
Vancomycin is educationally associated with: Treatment of enterococcal infections, Surgical prophylaxis in beta-lactam allergic patients, Treatment of C. difficile colitis, Treatment of MRSA infections, Prophylaxis in neutropenic patients, Treatment of Clostridioides difficile colitis, Treatment of CNS infections (meningitis). Educational only — not medical advice.
How is Vancomycin administered?
Recorded routes of administration: Intrathecal, Intravenous, Oral, Topical.
What are the potential side effects of Vancomycin?
Reported adverse effects include: Thrombophlebitis, Thrombocytopenia, Ototoxicity, Hypotension, Red‑man syndrome, Red man syndrome, Neutropenia, Nephrotoxicity. This list is not exhaustive — consult a qualified clinician.
Who should avoid Vancomycin?
Recorded contraindications: Severe pre-existing hearing loss, Known hypersensitivity to vancomycin, Hypersensitivity to vancomycin, Severe renal impairment with no dose adjustment, Vancomycin-resistant organisms (VRE). Consult a qualified clinician before use.