Vancomycin

Vancomycin is an antibiotic that is used primarily for treatment of gram-positive infections. Vancomycin has activity against methicillin resistant staphylococcus and streptococcus species, which is the primary indication for utilization.  Vancomycin works by inhibiting cell wall synthesis, altering permeability of the cell membrane, and inhibiting RNA synthesis.

Vancomycin is available in an intravenous and oral formulation. The oral formulation is not systemically absorbed and is used for the treatment of clostridium difficile infections of the gut. 

Vancomycin flushing syndrome (Red-man syndrome), which is characterized by an intense flushing reaction, is a known side effect and can be mitigated by slowing the medication infusion among other treatments.  

Class Drugs

• Vancomycin

Class Mechanism of Action

Three mechanisms of action:

• Inhibits synthesis of cell wall

• Alters permeability of cell membrane

• Inhibits RNA synthesis

Class Applications

Gram (+) Cocci

• S. aureus including MRSA

• S. epidermidis including MRSE

• S. pneumoniae

• Group A, B, and C streptococcus

• Enterococcus faecalis

Gram (+) Bacilli

• Listeria monocytogenes

Anaerobic

• Clostridium species

Oral form of drug is used against C. difficile as it is not systemically absorbed.

Class Adverse Effects

Resistance has developed in strains of Enterobacteriaceae and other bacteria

Vancomycin Flushing Syndrome (Red Man Syndrome)

• Flushing reaction that occurs with fast administration of vancomycin

• Reaction is limited by reducing rate of infusion of vancomycin

Drug Table

Drug Name	Application	Comments	Image
Vancomycin		Oral formulation reserved for C. difficile as it is not systemically absorbed	"Van" "Comb" "Mice"