To reduce the development of drug-resistant bacteria and maintain the effectiveness of vancomycin and other antibacterial drugs, vancomycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.
Sterile Vancomycin Hydrochloride, USP is a lyophilized powder, for preparing intravenous (IV) infusions. Each Pharmacy Bulk Package contains vancomycin hydrochloride equivalent to 5 grams of vancomycin base. When reconstituted as directed each 10 mL contains 500 mg and each 20 mL contains 1 gram.
Vancomycin hydrochloride is an off-white to tan colored lyophilized powder. It may contain hydrochloric acid and/or sodium hydroxide for pH adjustment. When reconstituted with Sterile Water for Injection, USP it forms a clear solution with the pH of the solution between 2.5 and 4.5. This product is oxygen sensitive.
The bactericidal action of vancomycin results primarily from inhibition of cell-wall biosynthesis. In addition, vancomycin alters bacterial-cell-membrane permeability and RNA synthesis. There is no cross-resistance between vancomycin and other antibiotics. Vancomycin is not active in vitro against gram-negative bacilli, mycobacteria, or fungi.
The combination of vancomycin and an aminoglycoside acts synergistically in vitro against many strains of Staphylococcus aureus, Streptococcus bovis, enterococci, and the viridans group streptococci.
Mechanism of Action: Vancomycin inhibits transpeptidation by binding to D-alanyl-D-alanine residues of the bacterial cell wall.
Vancomycin is excreted in human milk. Caution should be exercised when vancomycin is administered to a nursing woman. Because of the potential for adverse events, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Infusion related: Red man’s syndrome, pruritus, (histamine release)
Other: Drug fever
Dosage: IV: 1g, 2g, 5g, 10g, 500mg PO: 125mg, 250mg capsules
Endocarditis: 30mg/kg/day divided q12h x 4-6 weeks; add gentimicin initial 3-5 days for synergy against Staphylcoccus and 4-6 weeks for synergy against Enterococcus
Pseudomembranous enterocolitis: 500mg-2g PO divided daily q6-8h x 7-10 days
Bacterial infection by susceptible strains: 2 grams/day divided IV q6-12h
Dosing in pediatrics:
Bacterial infection by usceptible strains: 10-15 mg/kg IV every 6-8h
Meningitis: 60 mg/kg/day divided IV q6h
Drug Interactions: Warfarin: Increased risk of bleeding
Pregnancy Risk Factor: C
Vancomycin (Various generic manufacturers worldwide): Biovancomin – Biosintetica, Brazil : Copovan – Biologici Italia : Diatracin – Dista, Spain : Edicin – Lek, Hungary Thailand, and Czech Republic : Estavam – Precimex, Mexico : Farmaciclin Uno, Italy : Ifavac Andromaco, Mexico : Levovanox Levofarma, Italy : Lyphocin APP, Hong Kong : Maxivanil Max Farma, Italy : Orivan, Orion, Finland : Vagran – Dollder, Venezuela : Vamistol Demo, Greece : Vanaurus Pisa, Mexico : Vancam Abbott, Mexico : Vanclomin Teuto, Brazil : Vancoabbott Abbott, Brazil : Vancobehr Behrens, Venez. : Vancocid Biochimico, Brazil