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Vancomycin
1Division of Infectious Diseases and Internal Medicine, Mayo, Clinic, Rochester, MN 55905.
Abstract:
Vancomycin is a glycopeptide antibiotic that is active against staphylococci, streptococci, and other gram-positive bacteria. It is the drug of choice for the treatment of infections due to methicillin-resistant staphylococci, Corynebacterium jeikeium, and multiply resistant strains of Streptococcus pneumoniae. Vancomycin is an alternative treatment for serious staphylococcal and streptococcal infections, including endocarditis, when allergy precludes the use of penicillins and cephalosporins. Vancomycin is bactericidal against most strains of staphylococci and nonenterococcal streptococci. Although rare strains of staphylococci and enterococci that are resistant to vancomycin have been reported, bacterial resistance has thus far not emerged as a major clinical problem despite widespread use of vancomycin. When therapy is monitored by periodic determinations of serum concentrations of the drug and rapid infusion rates are avoided, vancomycin is rarely associated with serious toxicity.
Insights
Vancomycin effectively treats Gram-positive bacterial infections, including methicillin-resistant staphylococci. Despite rare resistance, it remains a safe and effective antibiotic when monitored properly.
Area of Science:
- Pharmacology
- Infectious Diseases
- Microbiology
Background:
- Vancomycin is a critical glycopeptide antibiotic for Gram-positive bacterial infections.
- It is a primary treatment for methicillin-resistant staphylococci and other resistant pathogens.
Purpose of the Study:
- To review the efficacy and safety of vancomycin.
- To assess the clinical significance of emerging vancomycin resistance.
Main Methods:
- Literature review of vancomycin's clinical use.
- Analysis of reported cases of bacterial resistance to vancomycin.
Main Results:
- Vancomycin demonstrates bactericidal activity against most target bacteria.
- Emergence of vancomycin resistance in staphylococci and enterococci is rare.
- Serious toxicity is infrequent with therapeutic drug monitoring and controlled infusion.
Conclusions:
- Vancomycin remains a valuable antibiotic for challenging Gram-positive infections.
- Careful monitoring and administration minimize toxicity risks.
- Bacterial resistance has not yet become a widespread clinical issue.