Vancomycin

Oral Antibiotics

Drug class: Glycopeptide Antibiotics

Vancomycin (VANCOCIN)（中文：萬古霉素）

Common Strengths

Vancomycin is commonly available in the following strengths:

• Intravenous (IV): 500 mg and 1 g vials
• Oral: 125 mg and 250 mg capsules

Drug Trade Names

Vancocin

Drug Usage

Vancomycin is a glycopeptide antibiotic primarily used to treat severe bacterial infections, particularly those caused by methicillin-resistant Staphylococcus aureus (MRSA).

Vancomycin is indicated for conditions such as:

• septicemia
• endocarditis
• skin infections
• bone infections
• pseudomembranous colitis caused by Clostridium difficile.

Mechanism of Action

Vancomycin works by inhibiting bacterial wall synthesis. It binds to the D-alanyl-D-alanine terminus of cell wall precursors, preventing the incorporation of these precursors into the growing peptidoglycan layer and leading to bacterial cell lysis.

Route of Administration

Vancomycin can be administered:

• Intravenously (IV) for systemic infections
• Orally for specific gastrointestinal infections like C. difficile colitis

Dosages

• Adults: IV: 1 to 1.5 g every 12 hours (elderly >65 years 500 mg every 12 hours or 1 g once daily)
• Child: 15 mg/kg every 8 hours, max. 2 g daily

<Surgical prophylaxis> 1 g for 1 dose

Side Effects

Frequency	Adverse reactions
Common Side Effects	Nausea
	Abdominal pain
	Flushing: Rapid intravenous infusion of vancomycin can lead to flushing, rash, and hypotension
Serious Side Effects	Nephrotoxicity: Acute Kidney Injury especially in elderly patients or those with pre-existing kidney conditions. It manifests as increased serum creatinine levels and decreased urine output.
	Ototoxicity: There is a risk of hearing loss which may present as tinnitus (ringing in the ears) or actual hearing impairment
	Allergic reactions: Serious allergic reactions including symptoms such as hives, difficulty breathing, swelling of the face or throat, and severe skin reactions like Stevens-Johnson syndrome and toxic epidermal necrolysis.
	Blood disorders: Neutropenia (low white blood cell count) and Thrombocytopenia (low platelet counts) which may increase the risk of infections and bleeding.