Vancomycin

Indications
 Oral
Staphylococcal enterocolitis
Adult: 0.5-2 g daily in 3-4 divided doses for 7-10 days. Use the lower dose unless ileus is impending or in severe infections.
Child: 40 mg/kg daily, given in 3-4 divided doses for 7-10 days. Not to exceed 2 g daily.
Renal impairment: Dose adjustment may be needed.
Oral
Antibiotic-associated colitis
Adult: 0.5-2 g daily in 3-4 divided doses for 7-10 days. Use the lower dose unless ileus is impending or in severe infections.
Child: 40 mg/kg daily, given in 3-4 divided doses for 7-10 days. Not to exceed 2 g daily.
Renal impairment: Dose adjustment may be needed.
Intravenous
Severe staphylococcal or other Gram-positive infections
Adult: 500 mg every 6 hr infused over at least 60 minutes or 1 g every 12 hr infused over 100 minutes.
Child: Various dosing regimens available. By IV infusion over at least 60 minutes: Neonates: <29 wk postmenstrual age: 15 mg/kg every 24 hr; 29-35 wk postmenstrual age: 15 mg/kg every 12 hr; >35 wk postmenstrual age: 15 mg/kg every 8 hr. 1 mth-18 yr: 15 mg/kg every 8 hr (max: 2 g daily), adjusted according to plasma concentrations.
Renal impairment: Various nomograms available. Initial IV dose of 15 mg/kg with subsequent dosage based on renal function and serum concentrations of the drug.
Intravenous
Osteomyelitis
Adult: 500 mg every 6 hr infused over at least 60 minutes or 1 g every 12 hr infused over 100 minutes.
Child: Various dosing regimens available. By IV infusion over at least 60 minutes: Neonates: <29 wk postmenstrual age: 15 mg/kg every 24 hr; 29-35 wk postmenstrual age: 15 mg/kg every 12 hr; >35 wk postmenstrual age: 15 mg/kg every 8 hr. 1 mth-18 yr: 15 mg/kg every 8 hr (max: 2 g daily), adjusted according to plasma concentrations.
Renal impairment: Various nomograms available. Initial IV dose of 15 mg/kg with subsequent dosage based on renal function and serum concentrations of the drug.
Intravenous
Septicaemia
Adult: 500 mg every 6 hr infused over at least 60 minutes or 1 g every 12 hr infused over 100 minutes.
Child: Various dosing regimens available. By IV infusion over at least 60 minutes: Neonates: <29 wk postmenstrual age: 15 mg/kg every 24 hr; 29-35 wk postmenstrual age: 15 mg/kg every 12 hr; >35 wk postmenstrual age: 15 mg/kg every 8 hr. 1 mth-18 yr: 15 mg/kg every 8 hr (max: 2 g daily), adjusted according to plasma concentrations.
Renal impairment: Various nomograms available. Initial IV dose of 15 mg/kg with subsequent dosage based on renal function and serum concentrations of the drug.
Intravenous
Soft tissue infections
Adult: 500 mg every 6 hr infused over at least 60 minutes or 1 g every 12 hr infused over 100 minutes.
Child: Various dosing regimens available. By IV infusion over at least 60 minutes: Neonates: <29 wk postmenstrual age: 15 mg/kg every 24 hr; 29-35 wk postmenstrual age: 15 mg/kg every 12 hr; >35 wk postmenstrual age: 15 mg/kg every 8 hr. 1 mth-18 yr: 15 mg/kg every 8 hr (max: 2 g daily), adjusted according to plasma concentrations.
Renal impairment: Various nomograms available. Initial IV dose of 15 mg/kg with subsequent dosage based on renal function and serum concentrations of the drug.
Intravenous
Prophylaxis of endocarditis
Adult: For patients undergoing dental, oral or upper respiratory tract surgery: 1 g 1 hr before surgery. For patients undergoing GI or genitourinary procedure: 1 g w/ 1.5 mg/kg gentamicin 1 hr before surgery. Routine prophylaxis is not recommended; recommended only for patients undergoing invasive procedures and in patients w/ underlying cardiac conditions that may put them at higher risk of adverse effects should infection occur.
Child: For patients undergoing dental, oral or upper respiratory tract surgery: 20 mg/kg 1 hr before surgery. For patients undergoing GI or genitourinary procedure: 20 mg/kg w/ 2 mg/kg gentamicin 1 hr before surgery. Routine prophylaxis is not recommended; recommended only for patients undergoing invasive procedures and in patients w/ underlying cardiac conditions that may put them at higher risk of adverse effects should infection occur.
Renal impairment: Dose adjustment may be needed.

Reconstitution: Add 10 or 20 ml of sterile water for Inj to a 500 mg or 1 g of vancomycin vial, respectively, to yield a concentration of 50 mg/ml. For intermittent IV infusion, the reconstituted solutions containing 500 mg or 1 g may be further diluted with at least 100 ml or at least 200 ml respectively and infused over a period of at least 1 hr. Suitable diluents include 5% dextrose Inj or sodium chloride 0.9%. If intermittent infusion is not feasible, continuous IV infusion may be used with the required daily dose of reconstituted vancomycin added to a sufficient volume of diluents and infused over 24 hr.
Incompatibility: Incompatible with alkaline preparations or drugs unstable at low pH. Y-site incompatibility: Albumin, amphotericin B cholesteryl sulfate complex, omeprazole, cefepime, gatifloxacin, heparin, idarubicin. Syringe incompatibility: Heparin. Admixture incompatibility: Amobarbital, chloramphenicol, pentobarbital, phenobarbital, phenytoin, chlorothiazide, dexamethasone sodium phosphate, penicillin G potassium.
Contraindications
 Hypersensitivity to the drug; history of impaired hearing; IM administration.
Warnings / Precautions
 Renal impairment; neonates, elderly, pregnancy and lactation. Administer by slow IV only. Decrease thrombophlebitis by giving vancomycin slowly as a dilute solution (2.5-5 mg/ml) and rotate infusion sites frequently. Keep rate of infusion ≤10 mg/min. Serum trough vancomycin levels to be kept at 5-20 mcg/ml depending on severity of infections and sites of infection. Monitor renal function, blood counts and auditory functions regularly. Discontinue if tinnitus develops.
Adverse Reactions
 Ototoxicity, nephrotoxicity, eosinophilia, "red-man" syndrome (e.g. flushing, hypotension, erythema), urticaria, thrombophloebitis, hypersensitivity reactions.
Potentially Fatal: Stevens-Johnson syndrome; toxic epidermal necrolysis, blood dyscrasias such as neutropenia or thrombocytopenia.
Drug Interactions
 Risk of increased nephrotoxicity with concomitant aminoglycosides, cisplatin, NSAIDs, amphotericin B, polymycin B, colistin or other nephrotoxic agents. Increased neuromuscular blockade with concomitant use of suxamethonium or vecuronium. Increased risk of ototoxicity with other aminoglycoside antibiotics, loop diuretics and ethacrynic acid. Increased risk of toxicity with methotrexate. Decreased vancomycin levels with dopamine, dobutamine. Increased risk of neutropenia with zidovudine.
See Below for More vancomycin Drug Interactions
Mechanism of Actions
 Vancomycin, a glycopeptide antibiotic, is used in the treatment of severe staphylococcal or other gram positive infections where other drugs cannot be used due to resistance or intolerance. It prevents the transfer and addition of muramylpentapeptide building blocks that make up the peptidoglycan molecule thus inhibiting formation of peptidoglycan polymers of the bacterial cell wall. It is active aginst Staphylococci eg, S. aureus, S. epidermidis, S. pneumoniae, Str. pyrogenes and some strains of Group B streptococci, Clostridium difficile, Actinomyces species, Bacillus anthracis, Corynebacterium species, some lactobacilli and Listeria species. Vancomycin demostrates concentration-independent or time dependent killing.
Absorption: Poorly absorbed from the GI tract; may be increased if GI tract is inflamed. 60% of intraperitoneal dose absorbed through the peritoneal cavity in 6 hr.
Distribution: Extracellular fluids eg, pleural, ascitic, synovial, pericardial fluids; bile (small amounts), CSF (little diffusion); crosses the placenta and enters breast milk. Protein-binding: 55%.
Metabolism: Minimal or no metabolism.
Excretion: Via the kidneys by glomerular filtration (80-90% as unchanged); 4-6 hr (elimination half-life), prolonged in renal impairment (7.5 days in anephric).
Administration
 May be taken with or without food.
Storage Conditions
 Intravenous: Store at 15-30°C. Oral: Store at 15-30°C.
ATC Classification
 J01XA01 - vancomycin ; Belongs to the class of glycopeptide antibacterials. Used in the systemic treatment of infections.
A07AA09 - vancomycin ; Belongs to the class of antibiotics. Used in the treatment of intestinal infections.
Storage
 Intravenous: Store at 15-30°C. Oral: Store at 15-30°C.
Available As
  • Vancomycin 1000 mg
  • Vancomycin 125 mg
  • Vancomycin 500 mg
  • Vancomycin 500mg

    • Subscribe for latest updates

    Subscribe to our e-mail newsletter to receive updates.

    No comments yet.

    Post Review about Vancomycin


    Vancomycin Containing Brands

    We are Developing Our database, More results coming soon.

    Vancomycin is used in following diseases

    We are Developing Our database, More results coming soon.

    Drug - Drug Interactions of Vancomycin

    We are Developing Our database, More results coming soon.