Source:http://www4.wiwiss.fu-berlin.de/dailymed/resource/drugs/2347
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Vancomycin Hydrochloride (Injection, Solution)
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Vancomycin
Injection, USP in the GALAXY plastic container (PL 2040) is intended for
intravenous use only. Vancomycin in the GALAXY Container (PL 2040
Plastic) is not to be
administered orally. An infusion rate of 10 mg/min or less
is associated with fewer infusion-related events (see ADVERSE
REACTIONS). Infusion related events may occur, however, at
any rate or concentration.<br/>Patients With
Normal Renal Function:<br/>Adults: The
usual daily intravenous dose is 2 g divided either as
500 mg every 6 hours or 1 g every 12 hours. Each dose
should be administered at no more than 10 mg/min or over
a period of at least 60 minutes, whichever is longer.
Other patient factors, such as age or obesity, may call
for modification of the usual intravenous daily
dose.<br/>Pediatric
patients: The
usual intravenous dosage of vancomycin is 10 mg/kg per
dose given every 6 hours. Each dose should be
administered over a period of at least 60 minutes. Close
monitoring of serum concentrations of vancomycin may be
warranted in these patients.<br/>Neonates: In
pediatric patients up to the age of 1 month, the total
daily intravenous dosage may be lower. In neonates, an
initial dose of 15 mg/kg is suggested, followed by 10
mg/kg every 12 hours for neonates in the 1st week of
life and every 8 hours thereafter up to the age of 1
month. Each dose should be administered over 60 minutes.
In premature infants, vancomycin clearance decreases as
postconceptional age decreases. Therefore, longer dosing
intervals may be necessary in premature infants. Close
monitoring of serum concentrations of vancomycin is
recommended in these patients.<br/>Patients
With Impaired Renal Function and Elderly Patients: Dosage adjustment must be made in patients with
impaired renal function. In the elderly, greater dosage
reductions than expected may be necessary because of
decreased renal function. Measurement of vancomycin
serum concentrations can be helpful in optimizing
therapy, especially in seriously ill patients with
changing renal function. Vancomycin serum concentrations
can be determined by use of microbiologic assay,
radioimmunoassay, fluorescence polarization immunoassay,
fluorescence immunoassay, or high-pressure liquid
chromatography. If creatinine clearance can be measured
or estimated accurately, the dosage for most patients
with renal impairment can be calculated using the
following table. The dosage of vancomycin per day in mg
is about 15 times the glomerular filtration rate in
mL/min: The
initial dose should be no less than 15 mg/kg, even in
patients with mild to moderate renal insufficiency. The
table is not valid for functionally anephric patients.
For such patients, an initial dose of 15 mg/kg of body
weight should be given to achieve prompt therapeutic
serum concentrations. The dose required to maintain
stable concentrations is 1.9 mg/kg/24 h. In patients
with marked renal impairment, it may be more convenient
to give maintenance doses of 250 to 1,000 mg once every
several days rather than administering the drug on a
daily basis. In anuria, a dose of 1,000 mg every 7 to 10
days has been recommended. When only the serum creatinine concentration is known,
the following formula (based on sex, weight, and age of
the patient) may be used to calculate creatinine
clearance. Calculated creatinine clearances (mL/min) are
only estimates. The creatinine clearance should be
measured promptly. The
serum creatinine must represent a steady state of renal
function. Otherwise, the estimated value for creatinine
clearance is not valid. Such a calculated clearance is
an overestimate of actual clearance in patients with
conditions: (1) characterized by decreasing renal
function, such as shock, severe heart failure, or oliguria; (2) in which a normal relationship between
muscle mass and total body weight is not present, such
as obese patients or those with liver disease, edema, or
ascites; and (3) accompanied by debilitation,
malnutrition, or inactivity. The safety and efficacy of
vancomycin administration by the intrathecal
(intralumbar or intraventricular) routes have not been
established. Intermittent infusion is the recommended method of
administration.<br/>Directions for use
of Vancomycin Injection, USP in GALAXY plastic container (PL 2040): Vancomycin
Injection, USP in GALAXY plastic container (PL 2040) is for intravenous administration only.<br/>Storage: Store in a freezer capable of maintaining a temperature
at or below -20��C (-4��F).<br/>Thawing of
Plastic Containers:: 1.
Thaw frozen containers at room temperature (25��C/77��F) or under refrigeration (5��C/41��F). DO NOT FORCE THAW BY IMMERSION IN
WATER BATHS OR BY MICROWAVE IRRADIATION. 2.
Check for minute leaks by squeezing the bag firmly. If
leaks are detected, discard solution because sterility
may be impaired. 3.DO NOT ADD SUPPLEMENTARY
MEDICATION. 4.
Visually inspect the container for particulate matter
and discoloration. Components of the solution may
precipitate in the frozen state and should dissolve with
little or no agitation after the solution has reached
room temperature. Potency is not affected. If after
visual inspection, the solution is discolored or remains
cloudy, an insoluble precipitate is noted, or any seals
or outlet ports are not intact, the container should be
discarded. 5.
The thawed solution in GALAXY plastic container (PL
2040) remains chemically stable for 72 hours at room
temperature (25��C/77��F) or for 30 days when stored under
refrigeration (5��C/41��F). 6.Do not refreeze thawed
antibiotics.<br/>Preparation
for Intravenous Administration:: 1.
Suspend container from eyelet support. 2.
Remove protector from outlet port at bottom of
container. 3.
Attach administration set. Refer to complete directions
accompanying set. 4.
Use sterile equipment. Caution: Do not
use plastic containers in series connections. Such use
could result in an embolism due to residual air being
drawn from the primary container before administration
of the fluid from the secondary container is complete. Rx
only.
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| dailymed-instance:descripti... |
Vancomycin
Injection, USP in the GALAXY plastic container (PL 2040) contains
vancomycin, added as Vancomycin Hydrochloride, USP. It is a tricyclic
glycopeptide antibiotic derived from Amycolatopsis orientalis (formerlyNocardia orientalis). The molecular formula is
CHClNO��HCl and the molecular weight is 1,485.71. 500 mg of the base is
equivalent to 0.34 mmol. Vancomycin hydrochloride has the following
structural formula: Vancomycin
Injection, USP in the GALAXY plastic container (PL 2040) is a frozen,
iso-osmotic, sterile, nonpyrogenic premixed 100 mL or 200 mL solution
containing 500 mg or 1 g Vancomycin respectively as Vancomycin
hydrochloride. Each 100 mL of solution contains approximately 5 g of
Dextrose Hydrous, USP. The pH of the solution may have been adjusted
with hydrochloric acid and/or sodium hydroxide. Thawed solutions have a
pH in the range of 3.0 to 5.0. After thawing to room temperature, this
solution is intended for intravenous use only. This GALAXY
container is fabricated from a specially designed multilayer plastic (PL
2040). Solutions are in contact with the polyethylene layer of this
container and can leach out certain chemical components of the plastic
in very small amounts within the expiration period. The suitability of
the plastic has been confirmed in tests in animals according to USP
biological tests for plastic containers as well as by tissue culture
toxicity studies.
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In subjects with
normal kidney function, multiple intravenous dosing of 1 g of vancomycin
(15 mg/kg) infused over 60 minutes produces mean plasma concentrations
of approximately 63��g/mL immediately after the completion of infusion,
mean plasma concentrations of approximately 23��g/mL 2 hours after
infusion, and mean plasma concentrations of approximately 8��g/mL 11
hours after the end of the infusion. Multiple dosing of 500 mg infused
over 30 minutes produces mean plasma concentrations of about 49��g/mL at
the completion of infusion, mean plasma concentrations of about 19��g/mL
2 hours after infusion, and mean plasma concentrations of about 10��g/mL
6 hours after infusion. The plasma concentrations during multiple dosing
are similar to those after a single dose. The mean
elimination half-life of vancomycin from plasma is 4 to 6 hours in
subjects with normal renal function. In the first 24 hours, about 75% of
an administered dose of vancomycin is excreted in urine by glomerular
filtration. Mean plasma clearance is about 0.058 L/kg/h, and mean renal
clearance is about 0.048 L/kg/h. Renal dysfunction slows excretion of
vancomycin. In anephric patients, the average half-life of elimination
is 7.5 days. The distribution coefficient is from 0.3 to 0.43 L/kg.
There is no apparent metabolism of the drug. About 60% of an
intraperitoneal dose ofvancomycin administered during peritoneal
dialysis is absorbed systemically in 6 hours. Serum concentrations of
about 10��g/mL are achieved by intraperitoneal injection of 30 mg/kg of
vancomycin. However, the safety and efficacy of the intraperitoneal use
of vancomycin has not been established in adequate and well-controlled
trials . Total systemic and
renal clearance of vancomycin may be reduced in the elderly. Vancomycin is
approximately 55% serum protein bound as measured by ultrafiltration at
vancomycin serum concentrations of 10 to 100��g/mL. After IV
administration of vancomycin, inhibitory concentrations are present in
pleural, pericardial, ascitic, and synovial fluids; in urine; in
peritoneal dialysis fluid; and in atrial appendage tissue. Vancomycin does not readily diffuse across normal meninges into the spinal fluid;
but, when the meninges are inflamed,penetration into the spinal fluid
occurs.<br/>Microbiology: The
bactericidal action of vancomycin results primarily from
inhibition of cell-wall biosynthesis. In addition, vancomycin
alters bacterial-cell-membrane permeability and RNA synthesis.
There is no cross-resistance between vancomycin and other
antibiotics. Vancomycin is not active in vitro against gram-negative
bacilli, mycobacteria, or fungi.<br/>Synergy: The
combination of vancomycin and an aminoglycoside acts synergistically in vitro
against many strains of Staphylococcus aureus, Streptococcus bovis, enterococci, and the viridans
group streptococci. Vancomycin
has been shown to be active against most strains of the
following microorganisms, both in vitro and in clinical
infections as described in the INDICATIONS
AND USAGE section.<br/>Aerobic
gram-positive microorganisms: Diphtheroids Enterococci
(e.g., Enterococcus
faecalis) Staphylococci, including Staphylococcus aureus and Staphylococcus epidermidis
(including heterogeneous methicillin-resistant strains) Streptococcus bovis Viridans
group streptococci The
following in vitro data
are available, but their clinical significance is unknown. Vancomycin
exhibits in vitro MIC's
of 1��g/mL or less against most (���90%) strains of streptococci
listed below and MIC's of 4��g/mL or less against most (���90%)
strains of other listed microorganisms; however, the safety and
effectiveness of vancomycin in treating clinical infections due
to these microorganisms have not been established in adequate
and well-controlled clinical trials.<br/>Aerobic
gram-positive microorganisms: Listeria monocytogenes Streptococcus pyogenes Streptococcus pneumoniae (including
penicillin-resistant strains) Streptococcus agalactiae<br/>Anaerobic
gram-positive microorganisms: Actinomyces species Lactobacillus species<br/>Susceptibility
Tests:<br/>Dilution
Techniques: Quantitative methods are used to determine
antimicrobial minimum inhibitory concentrations (MIC's).
These MIC's provide estimates of the susceptibility of
bacteria to antimicrobial compounds. The MIC's should be
determined using a standardized procedure. Standardized
procedures are based on a dilution method(broth or agar) or equivalent with standardized inoculum
concentrations and standardized concentrations of
vancomycin powder. The MIC values should be interpreted
according to the following criteria: The
current absence of data on resistant strains precludes
defining any categories other than���Susceptible���. Strains yielding MIC results suggestive of a���nonsusceptible���category should be submitted to a
reference laboratory for further testing. A
report of���Susceptible���indicates that the pathogen is
likely to be inhibited if the antimicrobial compound in
the blood reaches the concentrations usually achievable.
A report of���Intermediate���indicates that the result
should be considered equivocal, and, if the
microorganism is not fully susceptible to alternative, clinically feasible drugs, the test should be repeated.
This category implies possible clinical applicability in
body sites where the drug is physiologically
concentrated or in situations where high dosage of drug
can be used. This category also provides a buffer zone
which prevents small uncontrolled technical factors from
causing major discrepancies in interpretation. A report
of���Resistant���indicates that the pathogen is not likely
to be inhibited if the antimicrobial compound in the
blood reaches the concentrations usually achievable;
other therapy should be selected. Standardized
susceptibility test procedures require the use of
laboratory control microorganisms to control the
technical aspects of the laboratory procedures. Standard
vancomycin powder should provide the following MIC
values:<br/>Diffusion
Techniques: Quantitative methods that require measurement of zone
diameters also provide reproducible estimates of the
susceptibility of bacteria to antimicrobial compounds.
One such standardized procedurerequires the
use of standardized inoculum concentrations. This
procedure uses paper disks impregnated with 30-��g
vancomycin to test the susceptibility of microorganisms
to vancomycin. Reports from the laboratory providing results of the
standard single-disk susceptibility test with a 30-��g
vancomycin disk should be interpreted according to the
following criteria: The
current absence of data on resistant strains precludes
defining any categories other than���Susceptible���.
Strains yielding zone diameter results suggestive of a���nonsusceptible���category should be submitted to a
reference laboratory for further testing. Interpretation should be as stated above for results
using dilution techniques. Interpretation involves
correlation of the diameter obtained in the disk test
with the MIC for vancomycin. As
with standardized dilution techniques, diffusion methods
require the use of laboratory control microorganisms
that are used to control the technical aspects of the
laboratory procedures. For the diffusion technique, the
30-��g vancomycin disk should provide the following zone
diameters in these laboratory test quality control
strains:
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Vancomycin is
contraindicated in patients with known hypersensitivity to this
antibiotic. Solutions containing dextrose may be contraindicated in
patients with known allergy to corn or corn products.
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| dailymed-instance:supply |
Vancomycin
Injection, USP is supplied as a frozen, iso-osmotic, premixed solution
in a 100 mL or 200 mL single dose GALAXY plastic container (PL 2040) in
the following vancomycin-equivalent dose: Store at or below
-20��C (-4��F). See DIRECTIONS FOR USE
OF Vancomycin Injection, USP in GALAXY plastic container (PL
2040).
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General: Prolonged
use of vancomycin may result in the overgrowth of nonsusceptible
microorganisms. Careful observation of the patient is essential.
If superinfection occurs during therapy, appropriate measures
should be taken. In rare instances, there have been reports of
pseudomembranous colitis due to C.
difficile developing in patients who received
intravenous vancomycin. In order to
minimize the risk of nephrotoxicity when treating patients with
underlying renal dysfunction or patients receiving concomitant
therapy with an aminoglycoside, serial monitoring of renal
function should be performed and particular care should be taken
in following appropriate dosing schedules (see DOSAGE AND
ADMINISTRATION). Serial
tests of auditory function may be helpful in order to minimize
the risk of ototoxicity. Reversible
neutropenia has been reported in patients receiving vancomycin
(see ADVERSE
REACTIONS). Patients who will undergo prolonged
therapy with vancomycin or those who are receiving concomitant
drugs that may cause neutropenia should have periodic monitoring
of the leukocyte count. Vancomycin
is irritating to tissue and must be given by a secure
intravenous route of administration. Pain, tenderness, and
necrosis occur with inadvertent extravasation. Thrombophlebitis
may occur, the frequency and severity of which can be minimized
by slow infusion of the drug and by rotation of venous access
sites. There have
been reports that the frequency of infusion-related events
(including hypotension, flushing, erythema, urticaria, and
pruritus) increases with the concomitant administration of
anesthetic agents. Infusion-related events may be minimized by
the administration of vancomycin as a 60-minute infusion prior
to anesthetic induction. The safety and efficacy of vancomycin
administered by the intrathecal (intralumbar or
intraventricular) route or by the intraperitoneal route have not
been established by adequate and well-controlled trials. Reports
have revealed that administration of sterile vancomycin by the
intraperitoneal route during continuous ambulatory peritoneal
dialysis (CAPD) has resulted in a syndrome of chemical
peritonitis. To date, this syndrome has ranged from a cloudy
dialysate alone to a cloudy dialysate accompanied by variable
degrees of abdominal pain and fever. This syndrome appears to be
short-lived after discontinuation of intraperitoneal vancomycin. Prescribing
vancomycin in the absence of a proven or strongly suspected
bacterial infection or a prophylactic indication is unlikely to
provide benefit to the patient and increases the risk of the
development of drug-resistant bacteria.<br/>Drug Interactions: Concomitant
administration of vancomycin and anesthetic agents has been
associated with erythema and histamine-like flushing (see Usage
in Pediatrics under PRECAUTIONS) and anaphylactoid reactions (seeADVERSE
REACTIONS). Concurrent
and/or sequential systemic or topical use of other potentially
neurotoxic and/or nephrotoxic drugs, such as amphotericin B,
aminoglycosides, bacitracin, polymyxin B, colistin, viomycin, or
cisplatin, when indicated, requires careful
monitoring.<br/>Pregnancy:<br/>Teratogenic
Effects:<br/>Nursing Mothers: Vancomycin
is excreted in human milk. Caution should be exercised when
vancomycin is administered to a nursing woman. Because of the
potential for adverse events, a decision should be made whether
to discontinue nursing or to discontinue the drug, taking into
account the importance of the drug to the mother.<br/>Pediatric Use: In
pediatric patients, it may be appropriate to confirm desired
vancomycin serum concentrations. Concomitant administration of
vancomycin and anesthetic agents has been associated with
erythema and histamine-like flushing in pediatric patients (seeADVERSE
REACTIONS). The potential for toxic effects in
pediatric patients from chemicals that may leach from the
plastic containers into the single-dose, premixed intravenous
preparation has not been determined.<br/>Geriatric Use: The natural
decrement of glomerular filtration with increasing age may lead to elevated vancomycin serum concentrations if dosage is not
adjusted. Vancomycin dosage schedules should be adjusted in
elderly patients (see DOSAGE AND
ADMINISTRATION).<br/>Information for
Patients: Patients
should be counseled that antibacterial drugs including
vancomycin, should only be used to treat bacterial infections.
They do not treat viral infections (e.g., the common cold). When
vancomycin is prescribed to treat a bacterial infection,
patients should be told that although it is common to feel
better early in the course of therapy, the medication should be
taken exactly as directed. Skipping doses or not completing the
full course of therapy may (1) decrease the effectiveness of the
immediate treatment and (2) increase the likelihood that
bacteria will develop resistance and will not be treatable by
vancomycin or other antibacterial drugs in the future. Diarrhea is
a common problem caused by antibiotics which usually ends when
the antibiotic is discontinued. Sometimes after starting
treatment with antibiotics, patients can develop watery and
bloody stools (with or without stomach cramps and fever) even as
late as two or more months after having taken the last dose of
the antibiotic. If this occurs, patients should contact their
physician as soon as possible.
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| dailymed-instance:overdosag... |
Supportive care is
advised, with maintenance of glomerular filtration. Vancomycin is poorly
removed by dialysis. Hemofiltration and
hemoperfusion with polysulfone resin have been reported to result in
increased vancomycin clearance. The median lethal intravenous dose is
319 mg/kg in rats and 400 mg/kg in mice. To obtain
up-to-date information about the treatment of overdose, a good resource
is your certified Regional Poison Control Center. Telephone numbers of
certified poison control centers are listed in the Physicians' Desk
Reference (PDR). In managing overdosage, consider the possibility of
multiple drug overdoses, interaction among drugs, and unusual drug
kinetics in your patient.
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Vancomycin Hydrochloride
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| dailymed-instance:fullName |
Vancomycin Hydrochloride (Injection, Solution)
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| dailymed-instance:adverseRe... |
Infusion-Related
Events: During or
soon after rapid infusion of vancomycin, patients may develop
anaphylactoid reactions, including hypotension (see ANIMAL PHARMACOLOGY), wheezing, dyspnea, urticaria, or
pruritus. Rapid infusion may also cause flushing of the upper
body (���red neck���) or pain and muscle spasm of the chest and
back. These reactions usually resolve within 20 minutes but may
persist for several hours. Such events are infrequent if
vancomycin is given by a slow infusion over 60 minutes. In
studies of normal volunteers, infusion-related events did not
occur when vancomycin was administered at a rate of 10 mg/min or
less.<br/>Nephrotoxicity: Renal
failure, principally manifested by increased serum creatinine or
BUN concentrations, especially in patients administered large
doses of vancomycin, has been reported rarely. Cases of
interstitial nephritis have also been reported rarely. Most of
these have occurred in patients who were given aminoglycosides
concomitantly or who had preexisting kidney dysfunction. When
vancomycin was discontinued, azotemia resolved in most patients.<br/>Gastrointestinal: Onset of
pseudomembranous colitis symptoms may occur during or after
antibiotic treatment .<br/>Ototoxicity: A few dozen
cases of hearing loss associated with vancomycin have been
reported. Most of these patients had kidney dysfunction or a
preexisting hearing loss or were receiving concomitant treatment
with an ototoxic drug. Vertigo, dizziness, and tinnitus have
been reported rarely.<br/>Hematopoietic: Reversible
neutropenia, usually starting 1 week or more after onset of
therapy with vancomycin or after a total dosage of more than 25
g, has been reported for several dozen patients. Neutropenia
appears to be promptly reversible when vancomycin is
discontinued. Thrombocytopenia has rarely been reported.
Although a causal relationship has not been established,
reversible agranulocytosis (granulocytes<500/mm3) has
been reported rarely.<br/>Phlebitis]: Inflammation at the injection site has been
reported.<br/>Miscellaneous: Infrequently, patients have been reported to have had
anaphylaxis, drug fever, nausea, chills, eosinophilia, rashes
including exfoliative dermatitis, Stevens-Johnson syndrome, and
vasculitis in association with administration of vancomycin. Chemical
peritonitis has been reported following intraperitoneal
administration of vancomycin .
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| dailymed-instance:warning |
Rapid bolus
administration (e.g., over several minutes) may be associated with
exaggerated hypotension, including shock, and, rarely, cardiac arrest.
Vancomycin should be administered over a period of not less than 60
minutes to avoid rapid-infusion-related reactions. Stopping the infusion
usually results in prompt cessation of these reactions. Ototoxicity has
occurred in patients receiving vancomycin. It may be transient or
permanent. It has been reported mostly in patients who have been given
excessive doses, who have an underlying hearing loss, or who are
receiving concomitant therapy with another ototoxic agent, such as an
aminoglycoside. Vancomycin should be used with caution in patients with
renal insufficiency because the risk of toxicity is appreciably
increased by high, prolonged blood concentrations. Dosage of
vancomycin must be adjusted for patients with renal dysfunction (seePRECAUTIONSand DOSAGE AND
ADMINISTRATION). Clostridium difficile associated
diarrhea (CDAD) has been reported with use of nearly all antibacterial
agents, including Vancomycin Injection, USP, and may range in severity
from mild diarrhea to fatal colitis. Treatment with antibacterial agents
alters the normal flora of the colon leading to overgrowth of C. difficile. C. difficile
produces toxins A and B which contribute to the development of CDAD.
Hypertoxin producing strains of C.
difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may
require colectomy. CDAD must be considered in all patients who present
with diarrhea following antibiotic use. Careful medical history is
necessary since CDAD has been reported to occur over twomonths after
the administration of antibacterial agents. If CDAD is
suspected or confirmed, ongoing antibiotic use not directed againstC. difficile may need to be
discontinued. Appropriate fluid and electrolyte management, protein
supplementation, antibiotic treatment of C.
difficile, and surgical evaluation should be instituted as
clinically indicated.
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Vancomycin is
indicated for the treatment of serious or severe infections caused by
susceptible strains of methicillin-resistant (beta-lactam-resistant)
staphylococci. It is indicated for penicillin-allergic patients, for
patients who cannot receive or who have failed to respond to other
drugs, including the penicillins or cephalosporins, and for infections caused by vancomycin-susceptible organisms that are resistant to other
antimicrobial drugs. Vancomycin is indicated for initial therapy when
methicillin-resistant staphylococci are suspected, but after
susceptibility data are available, therapy should be adjusted
accordingly. Vancomycin is
effective in the treatment of staphylococcal endocarditis. Its
effectiveness has been documented in other infections due to
staphylococci, including septicemia, bone infections, lower respiratory
tract infections, skin and skin structure infections. When
staphylococcal infections are localized and purulent, antibiotics are
used as adjuncts to appropriate surgical measures. Vancomycin has been
reported to be effective alone or in combination with an aminoglycoside
for endocarditis caused by Streptococcus
viridans or S.
bovis. For endocarditis caused by enterococci (e.g., E. faecalis), vancomycin has been
reported to be effective only in combination with an aminoglycoside. Vancomycin has been
reported to be effective for the treatment of diphtheroid endocarditis.
Vancomycin has been used successfully in combination with either
rifampin, an aminoglycoside, or both in early-onset prosthetic valve
endocarditis caused by S.
epidermidis or diphtheroids. Specimens for
bacteriologic cultures should be obtained in order to isolate and
identify causative organisms and to determine their susceptibilities to
vancomycin. To reduce the
development of drug-resistant bacteria and maintain the effectiveness of
vancomycin and other antibacterial drugs, vancomycin should be used only
to treat or prevent infections that are proven or strongly suspected to
be caused by susceptible bacteria. When culture and susceptibility
information are available, they should be considered in selecting or
modifying antibacterial therapy. In the absence of such data, local
epidemiology and susceptibility patterns may contribute to the empiric
selection of therapy.
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| dailymed-instance:name |
Vancomycin Hydrochloride
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