Vancomycin (Vancocin)

Category:

  • Antibiotic

Description:

  • Miscellaneous antibiotic

Indications:

  • Oral:

    • Staphylococcal enterocolitis and antibiotic-associated pseudomembranous colitis from C. difficile

  • Parenteral:

    • Severe staphylococcal infections, including methicillin-resistant staphylococci

  • Endocarditis

    • staphylococcal

    • streptococcal (S. viridans, S. bovis, S. faecalis (with aminoglycoside))

    • diphtheroid

    • prophylaxis

  • Pseudomembranous colitis and staphylococcal enterocolitis (C. difficile)

Contraindications:

  • None

Precautions:

  • Pregnancy category C, category B for pulvules

  • May cause ototoxicity and nephrotoxicity, therefore perform regular auditopry and renal function tests.

  • “Red Man Syndrome”: Rapid intravenous administration may be associated with exaggerated hypotension with or without maculopapular rash over the facem neck, upper chest, and extremities.  Administer IV over a 2 hour period.

  • May cause reversible neutropenia.

  • May cause tissue irritation at injection site to include pain, tenderness and necrosis

  • Complete full course of therapy.

Adverse Reactions (Side Effects):

  • Reversible neutropenia

  • Increased serum creatinine or BUN, especially with large doses

  • Hearing loss, vertigo, dizziness

  • Drug fever, nausea, chills, rashes

  • “Red Man Syndrome”

Dosage:

  • Administered orally (pulvules and solution) and by IV injection

  • Oral:

    • Adults: 500mg to 2 grams per day given in 3-4 divided doses for 7-10 days

    • Children: 40mg/kg/day in 3-4 divided doses for 7-10 days

  • Parenteral:

    • Adults: 500mg IV q6h or 1 gram IV q12h

    • Children: 10mg/kg IV per dose q6h

    • Infants and neonates: initial dose of 15mg/kg, then 10mg/kg q12h for first week of life and q8h thereafter up to age 1 year

  • Bacterial endocarditis prevention

    • 1 gram IV (children 20mg/kg) over 1-2 hours given with gentamicin 1.5mg.kg IV or IM

Back to Medical Corps Pharmacy Page