Vancomycin injection

Generic name: Vancomycin

Drug class: Glycopeptide antibiotic

Dosage form: Injectable solution (intravenous)

Route of administration: Intravenous (IV) infusion

Dose:

• Adults with normal renal function: 500 mg every 6 hours or 1,000 mg every 12 hours, administered over at least 60 minutes per dose. The total daily dose is typically 2,000 mg. Adjustments may be necessary based on patient factors such as age or obesity.
• Pediatric patients (1 month and older): 10 mg/kg per dose every 6 hours, administered over at least 60 minutes per dose. Close monitoring of serum concentrations may be warranted in these patients.
• Neonates (up to 1 month old): The total daily intravenous dosage may be lower. Specific dosing should be determined by a healthcare provider.
• Patients with renal impairment: Dosage adjustments are required. The initial dose should be no less than 15 mg/kg, even in patients with mild to moderate renal insufficiency. Maintenance doses are typically 1.9 mg/kg per 24 hours. In patients with marked renal impairment, maintenance doses may be administered once every several days rather than daily. Specific dosing should be determined by a healthcare provider.

Mechanism of action: Vancomycin inhibits bacterial cell wall synthesis by binding to the D-alanyl-D-alanine portion of cell wall precursors, leading to cell lysis and death. It is primarily effective against Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA).

Drug usage cases:

• Treatment of serious or severe infections caused by susceptible strains of methicillin-resistant (β-lactam-resistant) staphylococci.
• Treatment of infections in penicillin-allergic patients or those who cannot receive or have failed to respond to other drugs, including penicillins or cephalosporins.
• Treatment of infections caused by vancomycin-susceptible organisms that are resistant to other antimicrobial drugs.
• Effective in the treatment of staphylococcal endocarditis, septicemia, bone infections, lower respiratory tract infections, and skin and skin structure infections.

Drug contraindications:

• Known hypersensitivity to vancomycin.
• Solutions containing dextrose may be contraindicated in patients with known allergy to corn or corn products.

Side effects:

• Pain, redness, or swelling at the injection site.
• Flushing, mostly over the face, neck, and chest, during injection.
• Hearing loss or ringing in the ears (ototoxicity).
• Kidney injury, indicated by decreased urine output or swelling of the ankles, hands, or feet (nephrotoxicity).
• Severe diarrhea, which may be a sign of Clostridium difficile-associated diarrhea.
• Allergic reactions, including skin rash, itching, hives, swelling of the face, lips, tongue, or throat.
• Infusion-related reactions, such as chest pain, shortness of breath, or feeling faint or lightheaded.
• Redness, blistering, peeling, or loosening of the skin, including inside the mouth (rare but serious skin reactions).

Warnings:

• Administer vancomycin by intravenous infusion over at least 60 minutes to reduce the risk of infusion-related reactions. An infusion rate of 10 mg/min or less is associated with fewer infusion-related events.
• Regular monitoring of serum vancomycin concentrations is recommended to minimize the risk of nephrotoxicity and ototoxicity, especially in patients with renal impairment or those receiving concomitant nephrotoxic or ototoxic drugs.
• Vancomycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria to reduce the development of drug-resistant bacteria.
• Use caution in patients with a history of hearing loss or kidney disease, as vancomycin may exacerbate these conditions.
• Vancomycin may cause live bacterial vaccines (such as typhoid vaccine) to not work as well. Do not have any immunizations/vaccinations while using this medication unless your doctor tells you to.

Use during pregnancy or breastfeeding:

During pregnancy, vancomycin should be used only when clearly needed. Discuss the risks and benefits with your doctor. This medication passes into breast milk. Consult your doctor before breastfeeding.