Vancomycin Overview

Class and Trade Name

• Class: Glycopeptide antibiotic
• Trade Name: Vancosin

Mechanism of Action

• Inhibits cell wall synthesis
• Blocks bacterial growth
• Bactericidal: Kills existing infections

Therapeutic Uses

• Strong infections resistant to other medications
  • MRSA (Methicillin-resistant Staphylococcus aureus)
  • Infections of skin or bone
  • C. difficile (C. diff)
• Effective for C. diff only in oral form, not IV

Side Effects

• Vancomycin Flushing Syndrome (Red Man Syndrome)
  • Occurs with rapid IV infusion
  • Symptoms: Red rash on face, chest, extremities, flushing, itching, and hypotension
  • Action: Stop infusion immediately

Routes of Administration

• Intravenous (IV):
  • Most common for most infections
  • Infuse over 60 minutes (100 minutes if >1 gram)
  • Comes as a powder that is reconstituted
• Oral:
  • Primarily for C. diff

Monitoring and Administration Details

• Peak and Trough Levels:
  • Peak: Highest concentration in blood
  • Trough: Lowest concentration before next dose
  • Therapeutic Levels:
    • Peak: 20 to 40
    • Trough: 5 to 15
  • Report trough > 20 (too high)
• IV Site Monitoring:
  • Watch for thrombophlebitis (vein inflammation) and extravasation (medication leakage)

Key Points

• Effective against resistant infections like MRSA and C. diff (oral only)
• Stop infusion if Vancomycin Flushing Syndrome occurs
• Infuse IV Vancomycin over at least 60 minutes, longer for larger doses
• Always draw trough before next dose

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