Vancomycin
Also known as: Vancocin, Firvanq
A glycopeptide antibiotic used for serious gram-positive infections such as MRSA, and orally for C. difficile. FDA-approved. Prescription only.
Last updated
Mechanism of Action
Vancomycin is a glycopeptide that binds the D-alanyl-D-alanine terminus of peptidoglycan precursors in the bacterial cell wall. This blocks the transglycosylation and transpeptidation steps that cross-link the wall, which kills or halts growth of gram-positive bacteria. It is too large to cross the outer membrane of gram-negative organisms, so its spectrum is gram-positive only. Given orally it is barely absorbed, so it acts locally in the gut against Clostridioides difficile.
- Half-life
- ~4–6 hours (IV, normal kidney function); much longer in kidney impairment
- Administration Routes
- Intravenous, Oral
- Research Status
- Clinical
Reported Benefits
- Treats serious MRSA infections, including bacteremia, endocarditis and pneumonia
- Treats other serious gram-positive infections when beta-lactams can't be used
- Oral form treats Clostridioides difficile infection
- Used for surgical prophylaxis in selected patients
Potential Side Effects
- Kidney injury, especially at high exposures or with other nephrotoxic drugs
- Vancomycin infusion reaction (flushing, itching, rash) with fast infusion
- Hearing loss or tinnitus (rare)
- Low white blood cell counts with prolonged use
- Severe skin reactions (rare)
Common Dosing
Intravenous vancomycin is given by clinicians, usually in hospital or infusion settings, with doses based on the infection, body weight and kidney function. Current guidelines adjust doses to a target drug exposure (AUC) using blood levels, mainly to limit kidney injury. Oral vancomycin for C. difficile uses a separate fixed regimen. The prescribing clinician sets and supervises dosing.
The dosing information above is aggregated from research literature and anecdotal community reports for educational purposes only. It is not a recommendation, prescription, or medical advice. Peptides are sold as research chemicals only and are not intended for human use.
Contraindications
- Known hypersensitivity to vancomycin
- Caution with existing kidney disease or other nephrotoxic or ototoxic drugs
- Some premixed IV formulations contain excipients not recommended in pregnancy or for certain patients
No documented stacking partners for Vancomycin yet.
- View
Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: A revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists
2020
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A comparison of vancomycin and metronidazole for the treatment of Clostridium difficile-associated diarrhea, stratified by disease severity
2007