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glossary:vancomycin

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glossary:vancomycin [2007/09/07 18:06]
Pat O'Connor
glossary:vancomycin [2012/10/16 14:40] (current)
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 +Vancomycin is used to treat colitis ([[inflammation]] of the intestine caused by certain [[bacteria]]) that may occur after [[antibiotic]] treatment. Vancomycin is in a class of medications called glycopeptide antibiotics. It works by killing [[bacteria]] in the intestines. Vancomycin will not kill bacteria or treat infections in any other part of the body when taken by mouth. [[Antibiotic]]s will not work for colds, flu, or other viral infections.
  
 +In subjects with normal [[kidney]] function, multiple intravenous dosing of 1 g of vancomycin (15 mg/kg) infused over 60 minutes produces mean [[plasma]] concentrations of approximately 63 µg/mL immediately after the completion of infusion, mean plasma concentrations of approximately 23 µg/mL 2 hours after infusion, and mean plasma concentrations of approximately 8 µg/mL 11 hours after the end of the infusion. Multiple dosing of 500 mg infused over 30 minutes produces mean plasma concentrations of about 49 µg/mL at the completion of infusion, mean plasma concentrations of about 19 µg/mL 2 hours after infusion, and mean plasma concentrations of about 10 µg/mL 6 hours after infusion. The plasma concentrations during multiple dosing are similar to those after a single dose.
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 +The mean elimination half-life of Vancomycin from plasma is 4 to 6 hours in subjects with normal renal function. In the first 24 hours, about 75% of an administered dose of Vancomycin is excreted in urine by glomerular filtration. Mean plasma clearance is about 0.058 L/kg/h, and mean renal clearance is about 0.048 L/kg/h. Renal dysfunction slows excretion of vancomycin. In anephric patients, the average half-life of elimination is 7.5 days. The distribution coefficient is from 0.3 to 0.43 L/kg. There is no apparent metabolism of the drug. About 60% of an intraperitoneal dose of Vancomycin administered during peritoneal dialysis is absorbed systemically in 6 hours. Serum concentrations of about 10 µg/mL are achieved by intraperitoneal injection of 30 mg/kg of vancomycin. However, the safety and efficacy of the intraperitoneal use of Vancomycin has not been established in adequate and well-controlled trials (see PRECAUTIONS).
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 +Total systemic and renal clearance of Vancomycin may be reduced in the elderly.
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 +Vancomycin is approximately 55% serum protein bound as measured by ultrafiltration at Vancomycin serum concentrations of 10 to 100 µg/mL. After IV administration of vancomycin, inhibitory concentrations are present in pleural, pericardial,​ ascitic, and synovial fluids; in urine; in peritoneal dialysis fluid; and in atrial appendage tissue. Vancomycin does not readily diffuse across normal meninges into the spinal fluid; but, when the meninges are inflamed, penetration into the spinal fluid occurs.
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 +Microbiology
 +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.
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 +Synergy
 +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. ​
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 +Vancomycin has been shown to be active against most strains of the following [[microorganism]]s,​ both in vitro and in clinical infections as described in the INDICATIONS AND USAGE section.
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 +Aerobic gram-positive microorganisms
 +Diphtheroids
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 +Enterococci (e.g., Enterococcus faecalis)
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 +[[Staphylococci]],​ including Staphylococcus aureus and Staphylococcus epidermidis (including heterogeneous methicillin-resistant strains)
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 +Streptococcus bovis
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 +Viridans group streptococci
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 +The following in vitro data are available, but their clinical significance is unknown.
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 +Vancomycin exhibits in vitro MIC’s of 1µg/mL or less against most (≥90%) strains of streptococci listed below and MIC’s of 4 µg/mL or less against most (≥90%) strains of other listed microorganisms;​ however, the safety and effectiveness of Vancomycin in treating clinical infections due to these microorganisms have not been established in adequate and well-controlled clinical trials.
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 +Aerobic [[gram-positive bacteria]] (microorganisms)
 +Listeria monocytogenes
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 +Streptococcus pyogenes
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 +Streptococcus pneumoniae (including [[penicillin]]-resistant strains)
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 +Streptococcus agalactiae
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 +Anaerobic [[glossary:​gram-positive bacteria| gram-positive microorganisms]]
 +Actinomyces species
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 +Lactobacillus species
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 +Susceptibility Tests
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 +Dilution Techniques ​
 +Quantitative methods are used to determine antimicrobial minimum inhibitory concentrations (MIC’s). These MIC’s provide estimates of the susceptibility of [[bacteria]] to antimicrobial compounds. The MIC’s should be determined using a standardized procedure. Standardized procedures are based on a dilution method1 (broth or agar) or equivalent with standardized inoculum concentrations and standardized concentrations of Vancomycin powder. ​
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 +Generic Name: Vancomycin hydrochloride ​
 +Dosage Form: Injection
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 + See also: * [[:​Infections Associated with Lymphedema]]
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 +           * [[http://​www.lymphedemapeople.com/​thesite/​lymphedema_antibiotics.htm|Lymphedema Antibiotics]]  ​
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 +           * [[http://​www.lymphedemapeople.com/​phpBB2/​viewtopic.php?​t=1079|Antibiotic Glossary]] ​
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glossary/vancomycin.txt · Last modified: 2012/10/16 14:40 (external edit)