Vancomycin

The drug Vancomycin is a systemic glycopeptide antibiotic. Other trade names: Vankocin, Vankoled, Vanmixan.

Indications of the vancomycin

Vancomycin is intended for the systemic treatment of inflammation of infectious etiology: septicemia, peritonitis, retroperitoneal abscess, lung and mediastinal abscess, meningitis, encephalitis, myelitis, acute endocarditis, osteomyelitis and pyogenic arthritis, pneumonia, pleurisy, enterocolitis. The use of Vancomycin is justified in cases when there is no antimicrobial effect of drugs of the penicillin group, erythromycin or cephalosporins.

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Release form

Vancomycin is available in the form of a lyophilized powder (in vials of 500 mg or 1 g) to prepare a solution used for infusion.

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Pharmacodynamics

The bactericidal action of vancomycin hydrochloride is due to its ability to bind to the amino acid components (acyl-D-alanyl-D-alanine) of the mucopeptide cytoplasmic bacteria membranes, which breaks their impermeability and inhibits the synthesis of RNA.

Vancomycin acts against gram-positive microbes: staphylococci, streptococci, enterococci, clostridia, corynebacteria (C. Diphtheriae), listeria, actinomycetes. However, against the gram-negative microbes, mycobacteria, fungi and protozoa this drug does not show activity.

[7], [8], [9], [10], [11], [12], [13], [14]

Pharmacokinetics

After the administration of Vancomycin into the vein, more than half the dose (55%) binds to plasma proteins; the drug enters the pleural, pericardial, synovial, spinal and other body fluids; penetrates the placental and blood-brain barrier.

The drug is almost not biotransformation, and 70-80% of vancomycin hydrochloride is eliminated through the kidneys - with an average half-life of 4-8 hours. Excretion of the drug in patients with chronic kidney failure occurs significantly longer.

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Dosing and administration

Vancomycin should be administered parenterally by intravenous drip infusion - with a maximum allowable rate of 10 mg per minute - for 60 minutes.

The standard daily intake for adults is 2 g (4 infusions of 500 mg or 2 injections of 1 g at the same intervals).

The dose for children is calculated at 10 mg per kilogram of body weight, the daily amount of the drug administered for 4 times (every 6 hours).

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Use of the vancomycin during pregnancy

Use Vancomycin during the first trimester of pregnancy is contraindicated; at later terms, the drug can be prescribed only if there are life indications.

Contraindications

Contraindications to the use of Vancomycin include cochlear neuritis (inflammation of the auditory nerve), marked renal failure, the first trimester of gestation, the period of breastfeeding. Relative contraindication is the presence of a history of hearing loss.

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Side effects of the vancomycin

Among the side effects of Vancomycin are: pain and epidermal necrosis at the injection site; urticaria, dermatitis, inflammation of the walls of blood vessels; lowering blood pressure; feverish condition; nausea; ringing in the ears and hearing loss; deterioration of the kidneys (with the development of interstitial nephritis); changes in the blood (thrombocytopenia, agranulocytosis, eosinophilia, etc.).

With the rapid administration of the drug, an anaphylactoid reaction arises (skin hyperemia, pain and muscle spasms in the upper body).

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Overdose

Exceeding the dose of Vancomycin leads to increased side effects of the drug, the elimination of which contributes to the normalization of the kidneys (with dialysis ineffective).

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Interactions with other drugs

Vancomycin is incompatible with β-lactam and aminoglycoside antibacterial drugs.

Simultaneous use of anesthetics, salicylates, loop diuretics can cause anaphylactic shock.

Antihistamines, antipsychotic drugs of the phenothiazines group, as well as thioxanthene derivatives, prevent the detection of symptoms of hearing impairment - one of the side effects of Vancomycin.

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Storage conditions

Vancomycin is a drug that is recommended to be stored in a dark place at t <+ 10 ° C.

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Shelf life

2 years.

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