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What is Vancomycin
Vancomycin is a parenteral glycopeptide antibiotic and is structurally related to teicoplanin, an investigational agent.
Vancomycin is obtained from Nocardia orientalis and is effective only for gram-positive bacteria. Although it is poorly absorbed after oral administration, vancomycin is occasionally administered orally to treat GI infections such as pseudomembranous colitis due to overgrowth of Clostridium difficile.
Vancomycin has been used clinically since 1956, but recent improvements in manufacturing have increased its purity and reduced its toxicity. Vancomycin was initially approved for use by the FDA in 1964.
Indications
- Actinomyces sp.
- anthrax
- Bacillus sp.
- bacteremia
- bone and joint infections
- brain abscess
- cellulitis
- Clostridium difficile
- Clostridium sp.
- community-acquired pneumonia
- Corynebacterium jeikeium
- Corynebacterium sp.
- endocarditis
- Enterococcus faecalis
- Enterococcus faecium
- Enterococcus sp.
- enterocolitis
- febrile neutropenia
- infectious arthritis
- Lactobacillus sp.
- Listeria monocytogenes
- lower respiratory tract infections
- mastitis
- meningitis
- neonatal mastitis
- nosocomial pneumonia
- orthopedic device-related infection
- osteomyelitis
- perinatal Group B streptococcal infection prophylaxis
- peritonitis
- pleural empyema
- pneumonia
- pseudomembranous colitis
- sepsis
- skin and skin structure infections
- Staphylococcus aureus (MRSA)
- Staphylococcus aureus (MSSA)
- Staphylococcus epidermidis
- Staphylococcus sp.
- Streptococcus agalactiae (group B streptococci)
- Streptococcus bovis
- Streptococcus pneumoniae
- Streptococcus pyogenes (group A beta-hemolytic streptococci)
- subdural empyema
- surgical infection prophylaxis
- vancomycin desensitization
- ventriculitis
- Viridans streptococci
Side Effects
- abdominal pain
- acute generalized exanthematous pustulosis (AGEP)
- agranulocytosis
- anaphylactoid reactions
- anemia
- azotemia
- back pain
- cardiac arrest
- chills
- constipation
- depression
- diarrhea
- dizziness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dyspnea
- eosinophilia
- erythema
- exfoliative dermatitis
- fatigue
- fever
- flatulence
- flushing
- headache
- hearing loss
- hemorrhagic occlusive retinal vasculitis
- hypokalemia
- hypotension
- infection
- injection site reaction
- insomnia
- interstitial nephritis
- nausea
- neutropenia
- paresthesias
- peripheral edema
- phlebitis
- pruritus
- pseudomembranous colitis
- rash
- red man syndrome
- renal failure (unspecified)
- sinus tachycardia
- Stevens-Johnson syndrome
- superinfection
- thrombocytopenia
- tinnitus
- toxic epidermal necrolysis
- urticaria
- vasculitis
- vertigo
- visual impairment
- vomiting
- wheezing
Monitoring Parameters
- audiometry
- serum creatinine/BUN
- serum vancomycin concentrations
Contraindications
- breast-feeding
- colitis
- corn hypersensitivity
- diarrhea
- extravasation
- geriatric
- GI disease
- hearing impairment
- heart failure
- inflammatory bowel disease
- infusion-related reactions
- intracameral administration
- intramuscular administration
- intrathecal administration
- intravitreal administration
- neonates
- nephrotoxicity
- ototoxicity
- pregnancy
- premature neonates
- pseudomembranous colitis
- renal disease
- renal failure
- renal impairment
- sodium restriction
- tinnitus
- ulcerative colitis
- vancomycin hypersensitivity
- viral infection
Interactions
- Acyclovir
- Adefovir
- Aldesleukin, IL-2
- Alfentanil
- Amikacin
- Aminoglycosides
- Amlodipine; Celecoxib
- Amphotericin B
- Amphotericin B cholesteryl sulfate complex (ABCD)
- Amphotericin B lipid complex (ABLC)
- Amphotericin B liposomal (LAmB)
- Aprotinin
- Atracurium
- Azelastine; Fluticasone
- Bacitracin
- Beclomethasone
- Benzonatate
- Beractant
- Betamethasone
- Bleomycin
- Budesonide
- Budesonide; Formoterol
- Calfactant
- Capreomycin
- Celecoxib
- Cholestyramine
- Ciclesonide
- Cidofovir
- Cisatracurium
- Cisplatin
- Colesevelam
- Colestipol
- Colistimethate, Colistin, Polymyxin E
- Corticosteroids
- Corticotropin, ACTH
- Cortisone
- Cyclosporine
- Deferasirox
- Deflazacort
- Dexamethasone
- Diclofenac
- Diclofenac; Misoprostol
- Dienogest; Estradiol valerate
- Diflunisal
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Donepezil; Memantine
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Doxacurium
- Drospirenone
- Drospirenone; Estradiol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix; Estradiol; Norethindrone acetate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir disoproxil fumarate
- Entecavir
- Esomeprazole; Naproxen
- Estradiol; Levonorgestrel
- Estradiol; Norethindrone
- Estradiol; Norgestimate
- Ethacrynic Acid
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Etodolac
- Famotidine; Ibuprofen
- Fenoprofen
- Fentanyl
- Fludrocortisone
- Flunisolide
- Flurbiprofen
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Formoterol; Mometasone
- Foscarnet
- Furosemide
- Gallium
- Gallium Ga 68 Dotatate
- Ganciclovir
- General anesthetics
- Gentamicin
- Gold
- Hyaluronidase, Recombinant; Immune Globulin
- Hydrocodone; Ibuprofen
- Hydrocortisone
- Ibandronate
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Immune Globulin IV, IVIG, IGIV
- Indomethacin
- Inotersen
- Kanamycin
- Ketoprofen
- Ketorolac
- Lamivudine; Tenofovir Disoproxil Fumarate
- Lansoprazole; Naproxen
- Leuprolide; Norethindrone
- Levonorgestrel
- Lithium
- Lorazepam
- Mannitol
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Memantine
- Mestranol; Norethindrone
- Methohexital
- Methotrexate
- Methylprednisolone
- Mivacurium
- Mometasone
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Neuromuscular blockers
- Nonsteroidal antiinflammatory drugs
- Norethindrone
- Norgestrel
- Oral Contraceptives
- Oxaliplatin
- Oxaprozin
- Pamidronate
- Pancuronium
- Paromomycin
- Pentamidine
- Piperacillin
- Piperacillin; Tazobactam
- Piroxicam
- Plazomicin
- Polymyxin B
- Polymyxins
- Poractant Alfa
- Prednisolone
- Prednisone
- Rapacuronium
- Remifentanil
- Rocuronium
- Rofecoxib
- Salicylates
- Segesterone Acetate; Ethinyl Estradiol
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
- Streptomycin
- Streptozocin
- Succinylcholine
- Sufentanil
- Sulindac
- Tacrolimus
- Telbivudine
- Tenofovir Alafenamide
- Tenofovir, PMPA
- Thiopental
- Tobramycin
- Tolmetin
- Tolvaptan
- Triamcinolone
- Trospium
- Tubocurarine
- Valacyclovir
- Valdecoxib
- Valganciclovir
- Vecuronium
- Warfarin
- Zoledronic Acid
