| name | Vancomycin |
| classification | Glycopeptide antibiotic |
| pharmacokinetics | | absorption | Poorly absorbed from the gastrointestinal tract. Administered intravenously (IV) for systemic infections. | | distribution | Distributes widely throughout the body, including the cerebrospinal fluid (CSF) with variable penetration into some tissues. | | metabolism | Minimal metabolism. Primarily eliminated unchanged by the kidneys. | | excretion | Renal excretion; dosage adjustments necessary in patients with renal impairment. |
|
| suggested dosage | | adults | | general | Dosage varies significantly depending on the infection type, severity, patient condition, renal function. Consult a physician for individualized dosing. | | example in infections | Loading dose, then maintenance doses of 15-20 mg/kg IV every 8-12 hours, titrated according to trough levels. Lower doses may be used for prophylaxis. |
| | important notes | Dosage should be carefully tailored to the patient's renal function to prevent toxicity. | | weight specific | Dosage adjusted for renal function based on creatinine clearance. For a 70kg patient, a typical starting dose without significant renal impairment is likely in the range specified above, but precise dosing is critical and needs medical supervision. |
|
| indications | Treatment of serious Gram-positive bacterial infections, particularly those caused by methicillin-resistant *Staphylococcus aureus* (MRSA) and *Streptococcus* species. |
| safety in pregnancy | Limited data available. Use only if potential benefit outweighs potential risks to the fetus. Consult with a physician. |
| safety in breastfeeding | Limited data available; potential for transfer into breast milk. Discontinue breastfeeding or use extreme caution when necessary. Consult with a physician. |
| side effects | | 1 | Nephrotoxicity (kidney damage) | | 2 | Ototoxicity (hearing loss) | | 3 | Red man syndrome (flushing, rash, itching, burning) | | 4 | Thrombophlebitis (inflammation of the vein) | | 5 | Allergic reactions | | 6 | Nausea, vomiting | | 7 | Diarrhea | | 8 | Headache | | 9 | Superinfections (opportunistic infections) | | 10 | Hypotension | | 11 | Fever |
|
| alternatives | |
| contraindications | Known hypersensitivity to vancomycin or other glycopeptides. |
| interactions | | 1 | Aminoglycosides (risk of nephrotoxicity and ototoxicity) | | 2 | Other nephrotoxic medications | | 3 | Drugs affecting renal function | | 4 | Drugs that can cause hearing loss |
|
| warnings and precautions | | 1 | Infusion reactions (red man syndrome): slow infusion rates to reduce symptoms | | 2 | Renal function monitoring: important to prevent kidney toxicity | | 3 | Careful monitoring of hearing: prevent ototoxicity | | 4 | Patient monitoring for signs and symptoms of allergic reactions | | 5 | Adjust doses for patients with renal insufficiency |
|
| additional informations | Requires careful monitoring of trough levels in most patient situations, especially in renal impairment or when dosage is being adjusted. It's crucial to ensure appropriate intravenous administration techniques to avoid phlebitis. |
