what is vancomycin used for
it is an antibiotic used for:
- Complicated skin and soft tissue infections
- Clostridium difficile infection
- Community + hospital acquired pneumonia
- Bone + joint infections
- Infective endocarditis
- Acute bacterial meningitis,
- Bacteraemia
how should vancomycin be administered for a systemic infection
By intravenous infusion
Vancomycin should NOT to be given by mouth for systemic infection due to lack of absorption
what are the contraindications for vancomycin
previous hearing loss with IV use
what is the caution for vancomycin use
absorption can be enhanced with inflammatory disorders of intestinal mucosa or with c.difficile-induced pseudomembranous colitis
(increased risk of side effects)
can vancomycin be used during pregnancy + breastfeeding
- only to be used in pregnancy if the benefit
outweighs the risk. - It is excreted in breastmilk but significant absorption by
the infant via oral administration is unlikely
what monitoring is needed for vancomycin
auditory function, blood count, hepatic and renal function, leucocyte count (risk of neutropenia or agranulocytosis with long term use)
what is the ideal therapeutic range (dose) for vancomycin
10-15mg/L “trough”
initial doses should be based on body-weight; subsequent dose adjustments should be based on serum-vancomycin concentrations to achieve targeted therapeutic concentrations (10-15mg/L trough)
why should you avoid rapid infusion of vancomycin
rapid infusion of vancomycin = risk of anaphylactoid reactions (immediate systemic reactions that mimic anaphylaxis )
what are the main side effects of vancomycin
- nephrotoxicity
- red man syndrome (a rash on the face, neck, and upper torso)
- neutropenia
- tinnitus (discontinue)
- Agranulocytosis
when is the serum-vancomycin normally measured after administration
- on the 2nd day of treatment for all patients if renal function normal
- earlier if impaired renal function
what is the initial dose of vancomycin based on
initial doses should be based on body-weight; subsequent dose adjustments should be based on serum-vancomycin concentrations to achieve targeted therapeutic concentrations
what are the symptoms of vancomycin toxicity
- red man syndrome
- ototoxicity (discontinue of tinnitus occurs)
- rash
- blood disorders
