What is Vancomycin HCl?

Vancomycin HCl is a parenteral glycopeptide antibiotic and is structurally related to Teicoplanin, an investigational agent. Vancomycin HCl is obtained from Nocardia orientalis (Streptomyces orientalis), which was isolated from soil of India and Indoneand,  is effective only for gram-positive bacteria.

How does Vancomycin HCl work?

Vancomycin HCl destroys Gram-positive bacteria, especially staphylococci and enterococci. It seems to function by inhibiting the formation of the bacterial cell wall, as does penicillin; it may also cause damage to the cell membrane.

The history of Vancomycin HCl

Vancomycin HCl is an anti-infection drug with two different life spans in medicine.

Vancomycin HCl has been used clinically since 1956, but recent improvements in manufacturing have increased its purity and reduced its toxicity. The FDA initially approved vancomycin HCl for use in 1964.  First introduced as an antibiotic, doctors rarely prescribed vancomycin HCl because of its limited bacterial target list. However, this drug regained popularity with physicians in the early 1970s as an effective substitute against bacteria that had developed resistance to the more popular antibiotics such as penicillins and cephalosporins. Today, vancomycin HCl is used in four major infection scenarios. It is most commonly used to treat resistant bacterial infections.

What is Vancomycin HCl used for?

Vancomycin is particularly useful against penicillin- and methicillin-resistant staphylococcal infections and for treating gram-positive infections in penicillin-allergic patients. Gram-negative bacteria and mycobacteria are resistant to vancomycin HCl . Synergistic bactericidal effects can be achieved when vancomycin HCl is combined with aminoglycosides against Streptococcus faecalis and methicillin-resistant organisms, but this increases possible toxicity. Vancomycin is useful against a wide variety of clinical infections due to these organisms, although it should not be used in patients with meningitis due to poor penetration into CSF.

This antibiotic may also be used to treat pseudomembranous colitis, which is an inflammation of the colon often caused by antibiotic-resistant strains of bacteria, namely Clostridium difficile. The drug also effectively treats cases of enterocolitis, or the inflammation of both the small intestine and the colon. Vancomycin is often used to prevent infections in patients with implanted devices such as artificial heart valves, intravenous (IV) catheters, or prosthetic hips. Available in both generic and brand name prescriptions, vancomycin HCl can be used individually as a single drug treatment or together in broad-based antibiotic combinations. This drug is available to treat both adults and children.

Vancomycin HCl mode of action

Vancomycin kills bacteria by preventing them from growing and multiplying. This drug interferes with the bacteria's ability to build new cell walls, a key component for the bacteria's outer structure. Inhibits the production of cell wall phospholipids and peptidoglycan polimerization.

The drug is intensely irritating to tissues and is usually used only for infections where microorganisms are resistant to penicillin. Vancomycin must be administered intravenously because it is not absorbed through the gastrointestinal tract. Mutant microorganisms resistant to vancomycin HCl are rare. Although vancomycin HCl is poorly absorbed after oral administration, it occasionally is administered orally to treat GI infections such as pseudomembranous colitis due to overgrowth of Clostridium difficile.

Vancomycin HCl pharmacokinetics

Generally, vancomycin HCl is only administered intravenously although oral administration is important in the treatment of some GI infections such as pseudomembranous colitis. Oral bioavailability of vancomycin HCl is too low to treat systemic infections. Patients with colitis, however, develop detectable serum levels following oral administration, especially if they have renal impairment. After intravenous administration of 1000 mg over 1 hour, plasma concentrations reach a peak of approximately 60 g/ml and fall to about 20 g/ml 2 hours after infusion. Vancomycin is distributed into most body tissues and fluids including pericardial, pleural, ascitic, and synovial fluids.

Vancomycin HCl side effects

Possible side effects: skin rashes, nausea, vomiting.

Rare adverse effects - ringing or buzzing in ears, loss of hearing.

Stop the medication and notify your physician immediately if you experience any adverse side effect to your hearing as a result of taking vancomycin HCl. High concentrations may lead to renal insufficiency.

Vancomycin HCl special conditions to observe

Pregnancy: Women who are pregnant should be under direct care of a physician before use.

Elderly: Older patients may be more vulnerable to hearing loss resulting from vancomycin HCl. Use the minimum doses needed and notify your physician immediately if your hearing is adversely affected.

Disclaimer:

Information on this page is provided for general information purposes. You should not make a clinical treatment decision based on information contained in this page without consulting other references including the package insert of the drug, textbooks and where relevant, expert opinion. We cannot be held responsible for any errors you make in administering drugs mentioned on this page, nor for use of any erroneous information contained on this page.