The use of vancomycin with its therapeutic and adverse effects: a review

Area of Science:

• Pharmacology
• Infectious Diseases
• Clinical Pharmacy

Background:

• Vancomycin (VCM) is a critical glycopeptide antibiotic for severe Gram-positive bacterial infections.
• Its use is essential against resistant strains like methicillin-resistant Staphylococcus aureus (MRSA).
• Vancomycin is also an alternative for patients with penicillin or cephalosporin allergies.

Purpose of the Study:

• To review the therapeutic applications of vancomycin.
• To identify and summarize the adverse effects associated with vancomycin therapy.
• To highlight controversies in vancomycin administration and their clinical implications.

Main Methods:

• A literature review was conducted.
• Articles were sourced from MEDLINE and SciELO databases.
• Searches included studies published in English, Portuguese, and Spanish.

Main Results:

• Key adverse effects include hypotension, phlebitis, nephrotoxicity, and ototoxicity.
• Other reported side effects encompass hypersensitivity reactions, Red Man Syndrome, neutropenia, chills, fever, and interstitial nephritis.
• Therapeutic efficacy is challenged by dose and administration controversies.

Conclusions:

• Vancomycin remains widely used, but suboptimal dosing and extended therapy risk increased minimum inhibitory concentrations (MICs).
• This can result in subtherapeutic levels, treatment failures, and adverse events.
• Further research is needed to optimize vancomycin administration protocols and ensure safe, effective patient outcomes through early monitoring.