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Vancomycin Key Points

Vancomycin Key Points #vancomycin #howtousevancomycin #indicationofvancomycin #doseofvancomycin #sideeffectsofvancomycin #clinicalusesofvancomycin #mrsa #vancomycinantibiotics Class: Glycopeptide antibiotic Spectrum: Narrow-spectrum (Gram-positive only), including: MRSA (Methicillin-resistant Staphylococcus aureus) Staphylococcus epidermidis (coagulase-negative staph) Enterococcus spp. (including some VRE strains) Clostridioides difficile (oral vancomycin only) Mechanism: Inhibits cell wall synthesis by binding to D-alanyl-D-alanine terminus of peptidoglycan precursors Indications: MRSA infections (bacteremia, endocarditis, pneumonia, osteomyelitis) Serious infections in penicillin-allergic patients C. difficile colitis (oral formulation only) Surgical prophylaxis (in penicillin-allergic patients for Gram-positive coverage) Dosing: Adults: 15–20 mg/kg/dose IV every 8–12 hours (adjusted based on trough levels) Loading dose: 25–30 mg/kg for severe infections (e.g., meningitis, sepsis) Pediatrics: 10–15 mg/kg/dose every 6–8 hours Oral (C. difficile): 125–500 mg every 6 hours Monitoring: Trough levels (drawn before 4th dose): Standard infections: 10–15 μg/mL Serious infections (e.g., meningitis, endocarditis): 15–20 μg/mL Peak levels (rarely needed, only in specific cases like renal failure) Administration: IV: Infuse over at least 60 mins (to avoid "Red Man Syndrome") Oral: Only for C. difficile (not absorbed systemically) Renal dosing: Adjust based on CrCl (primarily renally excreted) Side Effects: -Red Man Syndrome (flushing, rash, hypotension due to rapid infusion) Nephrotoxicity (risk increases with concurrent aminoglycosides, NSAIDs) Ototoxicity (rare, but risk with high troughs or prolonged use) Thrombophlebitis (irritation at IV site) Neutropenia (with prolonged therapy) Contraindications: Hypersensitivity to vancomycin Avoid in patients with severe hearing loss (ototoxicity risk) Drug Interactions: Aminoglycosides: Increased nephrotoxicity/ototoxicity Loop diuretics (e.g., furosemide): Enhanced ototoxicity -NSAIDs: Increased nephrotoxicity risk -Pregnancy/Lactation: Pregnancy (Category C): Use if benefits outweigh risks Breastfeeding: Low oral absorption—unlikely to affect infant -Unique Features: Time-dependent killing (maintain trough levels for efficacy) PO form not absorbed (only works for C. difficile in gut) First-line for MRSA (but increasing resistance concerns, e.g., VISA/VRSA) Disclaimer: Video is for educational purpose only Copyright Disclaimer Under Section 107 of the Copyright Act 1976, allowance is made for "fair use" for purposes such as criticism, comment, news reporting, teaching, scholarship, and research Fair use is a use permitted by copyright statute that might otherwise be infringing Non-profit, educational or personal use tips the balance in favor of fair use Some photos in the video are downloaded from Google Image. The picture used in this video is protected by the Fair Use Law, section 107 used for commentaries, criticisms, news reports or Education for transformative use. Thanks.