Vancomycin (Vancocin)

Category:

• Antibiotic

Description:

• Miscellaneous antibiotic

Indications:

• Oral:

  • Staphylococcal enterocolitis and antibiotic-associated pseudomembranous colitis from C. difficile

• Parenteral:

  • Severe staphylococcal infections, including methicillin-resistant staphylococci

• Endocarditis

  • staphylococcal

  • streptococcal (S. viridans, S. bovis, S. faecalis (with aminoglycoside))

  • diphtheroid

  • prophylaxis

• Pseudomembranous colitis and staphylococcal enterocolitis (C. difficile)

Contraindications:

• None

Precautions:

• Pregnancy category C, category B for pulvules

• May cause ototoxicity and nephrotoxicity, therefore perform regular auditopry and renal function tests.

• “Red Man Syndrome”: Rapid intravenous administration may be associated with exaggerated hypotension with or without maculopapular rash over the facem neck, upper chest, and extremities.  Administer IV over a 2 hour period.

• May cause reversible neutropenia.

• May cause tissue irritation at injection site to include pain, tenderness and necrosis

• Complete full course of therapy.

Adverse Reactions (Side Effects):

• Reversible neutropenia

• Increased serum creatinine or BUN, especially with large doses

• Hearing loss, vertigo, dizziness

• Drug fever, nausea, chills, rashes

• “Red Man Syndrome”

Dosage:

• Administered orally (pulvules and solution) and by IV injection

• Oral:

  • Adults: 500mg to 2 grams per day given in 3-4 divided doses for 7-10 days

  • Children: 40mg/kg/day in 3-4 divided doses for 7-10 days

• Parenteral:

  • Adults: 500mg IV q6h or 1 gram IV q12h

  • Children: 10mg/kg IV per dose q6h

  • Infants and neonates: initial dose of 15mg/kg, then 10mg/kg q12h for first week of life and q8h thereafter up to age 1 year

• Bacterial endocarditis prevention

  • 1 gram IV (children 20mg/kg) over 1-2 hours given with gentamicin 1.5mg.kg IV or IM