Vancomycin

Please note: This is for information only.

Refer to local guidelines for treatment recommendations


 

  • A glycopeptide antibiotic (closely related to teicoplanin).
  • Usual adult dose 1g BD IV but dose must be reduced in elderly patients or patients with renal impairment.
  • IV Vancomycin therapy requires monitoring of serum levels to ensure efficacy and minimise toxicity. IV Vancomycin must be given by slow IV infusion over at least 2 hours.
  • Oral vancomycin is NOT absorbed and cannot be used for systemic infections. It is a 2nd-line treatment for Clostridium difficile associated diarrhoea (125 mg PO QDS).

 

Main indications

  • Severe community-acquired pneumonia (in patients with a risk of MRSA)
  • 1st line therapy for suspected staphylococcal sepsis in patients with a risk of MRSA.
  • C.difficile infection

Active against most strains of:

  • Staphylococcus aureus (including MRSA)
  • Staph.epidermidis
  • Streptococci
  • Enterococci
  • Diptheroids
  • Clostridium difficile
  • Clostridium perfringens

Not active against:

  • Coliforms
  • Pseudomonas
  • Bacteroides
  • Vancomycin-resistant Entercocci
  • Vancomycin resistant enterococci (VRE) - becoming more prevalent due to widespread vancomycin use
  • A few strains of Staphylococcus aureus (GISA) and Staph.epidermidis are now vancomycin insensitive.