Vancomycin is not absorbed orally and intramuscular injection is painful. It acts by inhibition of cell wall synthesis. It is mainly excreted via urine.
SERIOUS INFECTIONS SUSPECTED TO BE CAUSED BY STAPHYLOCCOCCI OR STREPTOCOCCI SUCH AS ENDOCCARDITIS, LOWER RTI, SEPTICAEMIA, BONE INFECTION, SKIN AND SOFT TISSUE INFECTIONS: Adults: 500mg 6 hrly or 1g 12 hrly. Children and infants over 1 ,month: 40mg/kg/day in 4 divided doses. 60mg/kg/day in CNS infections. Neonates 8-30 days: 15mg/kg followed by 10mgmg/kg 8 hrly. Neonates less than 8 days old: 10mg/kg every 12 hrs after initial dose of 15mg/kg
PROPHYLAXIS DURING SURGICAL PROCEDURES SUCH AS CARDIAC VALVE REPLACEMENT, TOTAL HIP REPLACEMENT, PATIENTS WITH SEVERE INFECTIONS UNDERGOING DENTAL OR UPPER RT SURGERY: Adult: Infuse 1g over 30-60 mins before surgery starts. Children: 20mg/kg.
Bactericidal action through inhibition of the cell wall synthesis. It may also affect cell membrane permeability and RNA synthesis. Vancomycin is active against Staph. aureus, Staph.epidermidis including methicillian-resistant strains, Streptococci including Strep. pyogenes, Strep.pneumoniae, Strep.agalactiae, viridans group, Enterococcus faecalis, Clostriduim dificile, Diphtheroids, Listeria monocytogenes, Clostrdium spp etc.
Patients with Renal disease, inflammatory bowel disorders may have an increased chance of adverse effects. Rapid infusion may lead to sudden, profound fall in blood pressure, flushing,and itching (red man syndrome)
Effect & Precaution
Hypersensitivity reactions e.g. skin rash and anaphylaxis. Local pain and phlebitis at site of intravenous injection. Nausea, chills, fever, ototoxicity and nephrotoxicity. Hypotension, eosinophilia.
Cholestyramine, Colestipol : Use of these drugs with oral vancomycin may decrease the effects of oral vancomycin; oral vancomycin and these drugs should be taken several hours apart. Risk of increased nephrotoxicity with concommitant aminoglycosides. Neuromuscular blockade may occur if used together with non-depolarising agents.
Pregnancy: Use with caution
Breast Feeding: Use with caution
Man: Use with Caution.