In addition, vancomycin alters bacterial-cell-membrane permeability and RNA synthesis. There is no cross-resistance between vancomycin and other antibiotics. It is active only against gram-positive bacteria. It is not active against gram-negative bacilli, mycobacteria, or fungi. It is poorly absorbed via the GI system, which is why it is given most often parenterally.
Vancomycin is used in the treatment of serious infections involving gram positive organisms including Clostridium difficile (C.difficile or C.diff), methicillin-resistant Staphylococcal aureus (MRSA), and individuals susceptible to infection but are allergic to penicillin.
Peak and trough levels are drawn while the patient is receiving Vancomycin, because of the dose related risk of renal toxicity.
While rare, ototoxicity is another possible side effect associated with Vancomycin administration and is usually reversible. Patients with ototoxicity often present first with tinnitus.
If administered rapidly, patients may experience flushing, rash, pruritus, urticaria, tachycardia, and hypotension. Slow infusion, as well as prophylaxis with diphenhydramine avoids the release of histamine, which causes these symptoms.
This is a common side effect due to the irritating effect of the medication on the blood vessel wall. Diluting the IV solution, changing the IV site frequently, and administering the IV slowly can decrease the risk of thrombophlebitis.
Prior to giving the first dose of the medication, a culture and sensitivity test should be performed to identify the infectious organism.
Slow infusion of Vancomycin reduces the incidence of side effects such as Red Man Syndrome and thrombophlebitis.
It is important to administer both parenteral and oral preparations of the medication in equal intervals around the clock to maintain therapeutic blood levels.
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