Vancomycin

Glycopeptide antibiotic.

5–6 h

Clostridium spp., Corynebacterium diphtheriae, Enterococcus spp., Staph. aureus, coagulase-negative staphylococci, Streptococcus spp.

Severe infections caused by staphylococci, streptococci and enterococci with resistance to other antibiotics or penicillin allergy. Infections of foreign bodies (e.g. endoprostheses), endocarditis, osteomyelitis and pneumonia (in combination with rifampicin, fosfomycin or gentamicin).

Breastfeeding.

• Adults: 1-2 g/day in 2-4 ED each in 500 ml 5% glucose solution for at least 60 min. i.v.
• Children: 20-40 mg/kg bw/day
• infants and newborns: initial 15 mg/kg bw, maintenance dose during the first week of life 10 mg/kg every 12 hours, from the second week of life up to 1 month 10 mg/kg every 8 hours

Allergic reactions ( Red-Man-Syndrome)

Maculopapular exanthema

Erythema (exudative) multiforme

Stevens-Johnson syndrome

Toxic epidermal necrolysis.

Often eosinophilia, interstitial nephritis, fever, hearing disorders. If infusion is too fast, thrombophlebitis in the area of the infusion site.

Notice! In case of reduced renal function accumulation: nephrotoxicity and ototoxicity!

S.a. under AER: AER is the acronym for Vancomycin-resistant Enterococci. Vancomycin-resistant Enterococci are primarily recruited from the increasing reservoir of E. faecium isolates. They are mostly resistant to all glycopeptides.

Caution in combination with ototoxic drugs.

Pre-damage of the vestibular or cochlear apparatus, pregnancy.

Vancomycin Lilly, Vancomycin-ratiopharm, Vancomycin Abbott

1. Niikura T et al (2007) Vancomycin-impregnated calcium phosphate cement for methicillin-resistant Staphylococcus aureus femoral osteomyelitis. Orthopedics 30: 320-321