726 - Vancomycin

Vancomycin is a glycopeptide-antibiotic, which is administered in case of infections with gram-positive bacteria and employed against multi-resistant staphylococci as a reserve antibiotic. The active ingredient is gained from special actino-bacteria (Amycolatopsis orientalis) and works via the inhibition of the bacterial cell-wall synthesis; i.e. vancomycin is deposited at the free C-terminal end of the peptide side chain of the peptidoglycan gram-positive bacteria in the cell wall. This causes a disruption of the cross-linking in the cell wall and it thus becomes unstable, whereby the bacteria are caused to burst. Vancomycin however has no effect on gram-negative bacteria. Possible undesirable side effects can beneutropenia, over sensitiveness, ototoxicity and kidney functional disruptions.

Type of drug: Antibiotic
Metabolism: Not metabolised
Half life t½: 3-8h
Steady State: 1-2 days
TDM: recommended
Additional informations: A concentration above 10 mg/l should be achieved in any case in order to avoid resistence. A TDM is recommended for patients with modified pharmacokinetics: this applies to patients with overweight problems, kidney dysfunction or dysplasia.