Vancomycin

Vancomycin is a systemic glycopeptide antibiotic. Other trade names: Vancocin, Vancoled, Vanmixan.

Indications Vancomycin

Vancomycin is intended for systemic treatment of inflammations of infectious etiology: septicemia, peritonitis, retroperitoneal abscess, abscess of the lungs and mediastinum, meningitis, encephalitis, myelitis, acute endocarditis, osteomyelitis and pyogenic arthritis, pneumonia, pleurisy, enterocolitis. The use of Vancomycin is justified in cases of lack of antimicrobial effect of drugs of the penicillin, erythromycin or cephalosporin group.

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Release form

Vancomycin is available as a lyophilized powder (in 500 mg or 1 g vials) for the preparation of a solution used for infusions.

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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 membranes of bacteria, which disrupts their impermeability and inhibits RNA synthesis.

Vancomycin is effective against gram-positive microbes: staphylococci, streptococci, enterococci, clostridia, corynebacteria (C. diphtheriae), listeria, actinomycetes. However, this drug is not active against gram-negative microbes, mycobacteria, fungi and protozoa.

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Pharmacokinetics

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

The drug undergoes almost no 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 renal failure occurs significantly longer.

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Dosing and administration

Vancomycin should be administered parenterally by intravenous drip infusion – at a maximum rate of 10 mg per minute – over 60 minutes.

The standard daily dose for adults is 2 g (4 infusions of 500 mg or 2 administrations of 1 g at equal intervals).

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

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Use Vancomycin during pregnancy

Vancomycin is contraindicated during the first trimester of pregnancy; at later stages, the drug may be prescribed only if there are vital indications.

Contraindications

Contraindications to the use of Vancomycin include cochlear neuritis (inflammation of the auditory nerve), severe renal failure, first trimester of gestation, and breastfeeding. A relative contraindication is a history of hearing loss.

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Side effects Vancomycin

Side effects of Vancomycin include: pain and epidermal necrosis at the injection site; urticaria, dermatitis, inflammation of the walls of blood vessels; decreased blood pressure; fever; nausea; tinnitus and hearing loss; deterioration of kidney function (with the development of interstitial nephritis); changes in the blood (thrombocytopenia, agranulocytosis, eosinophilia, etc.).

With rapid administration of the drug, an anaphylactoid reaction occurs (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 is facilitated by normalizing kidney function (dialysis is ineffective).

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Interactions with other drugs

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

The simultaneous use of anesthetics, salicylates, and loop diuretics can cause anaphylactic shock.

Antihistamines, antipsychotics of the phenothiazine group, and thioxanthene derivatives prevent the detection of symptoms of hearing loss, one of the side effects of Vancomycin.

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Storage conditions

Vancomycin is one of the drugs 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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