New webinar on demand! Vancomycin is an antibiotic originally isolated from the bacteria Streptococcus orientalis. Vancomycin is a tricyclic glycopeptide antibiotic that prevents synthesis of peptidoglycan, the main component of bacterial cell walls. It is an effective antibiotic treatment against Gram-positive bacteria that contain peptidoglycan in their walls.
Oral vancomycin is given to treat Clostridiodes Clostridium difficile infections and infection-induced diarrhea. However, the drug has poor oral bioavailability and is broken down in the stomach and intestines before it can enter the bloodstream to treat systemic infections.
As a result, for systemic infections, vancomycin is given intravenously IV for better efficacy. MRSA and MRSE are both resistant to beta-lactam antibiotics for example, oxacillin , which are commonly used to treat most staph infections. Intravenous vancomycin can also be used for a variety of other serious or severe infections, including:. Vancomycin is also useful for treating infections in patients allergic to penicillin or cephalosporins. It is important to note that vancomycin and other antibiotics are not effective in treating viral infections.
New vancomycin dosing guidelines for the treatment of serious MRSA infections were published in by several leading pharmacy and infectious disease groups. Vancomycin is processed in the kidneys, and too much drug given at once can be damaging. In all cases, further dosing should be guided by blood concentrations.
For seriously ill patients, the guidelines suggest consideration of a loading dose which by definition is a one-time large dose that is given to a patient who is starting with no vancomycin in their blood. In order for vancomycin to work correctly, a certain concentration needs to be maintained in the blood. Vancomycin has a narrow therapeutic window, and it is easy to underdose or overdose a patient. Blood work is done to ensure vancomycin trough levels remain within this window to prevent organ damage or antibiotic resistance.
