Vancophar

Vancomycin HCl

Potentially life-threatening infections due to susceptible gm +ve organisms which cannot be treated by other effective, less toxic antimicrobial drugs eg, penicillins & cephalosporins. Methicillin resistant staphylococcal infection. Severe staphylococcal infections in patients who cannot receive or who have failed to respond to penicillins & cephalosporins or who have infections w/ staphylococci that are resistant to other antibiotics including methicillin. Staphylococcal endocarditis. Other infections due to staphylococci, including osteomyelitis, pneumonia, septicemia & soft tissue infections. Severe antibiotic-associated pseudomembranous colitis (caused by Clostridium difficile) & staphylococcal enterocolitis (oral vancomycin). Prophylaxis against endocarditis in patients at risk from dental or surgical procedures.

IV Adult 500 mg every 6 hr or 1 g every 12 hr administered at no >10 mg/min. Duration of therapy depends on type & severity of infections & patient response. Bacterial endocarditis 500 mg every 6 hr for min of 3 wk either alone or in combination w/ other antibiotics. Ped 10 mg/kg/dose every 6 hr administered over at least 60 min (total daily dose: 40 mg/kg). Neonate & young infant Initially 15 mg/kg, followed by 10 mg/kg every 12 hr in the 1st wk of life & every 8 hr thereafter until 1 mth of age. Impaired renal function Initially 15 mg/kg. CrCl 2 mL/min/kg 30.9 mg/kg daily, 1.5 mL/min/kg 23.2 mg/kg daily, 1 mL/min/kg 15.4 mg/kg daily, 0.5 mL/min/kg 7.7 mg/kg daily. Anephric patient 15 mg/kg loading dose w/ subsequent dose of 1.9 mg/kg daily. Anuria 1 g every 7-10 days. Haemodialysis 1 g every 7 days. Peritoneal dialysis Additional dose could be added to dialysate in 25 mcg/mL conc.

Hypersensitivity.

Infuse in diluted soln at rate not >10 mg/min to avoid rapid infusion-related reactions eg, severe hypotension (including shock & cardiac arrest), histamine like responses & maculopapular or erythematous rash ("red man's syndrome" or "red neck syndrome"). Risk of toxicity is increased by high blood conc or prolonged therapy. Monitor blood levels & adjust dosage if necessary in patients w/ renal impairment. Avoid concurrent or sequential use of other nephrotoxic drugs. Patients w/ inflammatory disorders of intestinal mucosa may be at risk of adverse reactions associated w/ parenteral administration. Avoid in patients w/ previous hearing loss. Serial testing of auditory function in patients >60 yr. Deafness may be preceded by tinnitus. Very irritating to tissue & causes inj site necrosis if injected IM; pain & thrombophlebitis. Periodic haematological studies, urine analysis, liver & renal function tests in all patients. Anaesth induced myocardial depression. Dilute doses well & slowly administer w/ close cardiac monitoring during anaesth. Delay position changes until infusion is completed to allow for postural adjustment. Renal impairment. Pregnancy & lactation. Elderly.

Permanent deafness in patients w/ compromised auditory or renal function, reversible deafness; hypotension, palpitations, substernal pressure, phlebitis; pruritus at inj site, generalised flushing, erythematous macular rash w/ intense pruritus over face, neck & upper body after rapid inj, tissue irritation & necrosis after IM inj or extravasation from IV site, bullous eruption disorders, rashes including exfoliative dermatitis, SJS, TEN & linear IgA bullous dermatosis; nausea, diarrhoea & occasional vomiting in leukaemic patients; overgrowth of non-susceptible organisms; transient elevations of urea & granular casts in urine; reversible neutropenia, eosinophilia; histamine release w/ chills, nausea, urticaria, macular rash, fever & rigors, anaphylactoid & hypersensitivity reactions, anaphylaxis; may cause severe inflammation or sloughing after subconjunctival inj; pain & muscle spasm of chest & back.

Erythema, histamine like flushing & anaphylactoid reactions w/ anaesth agents. Concurrent administration w/ other neurotoxic or nephrotoxic drugs eg, amphotericin B, streptomycin, neomycin, gentamicin, kanamycin, amikacin, tobramycin, bacitracin, polymyxin B, colistin & cisplatin. May aggravate ototoxicity w/ diuretics eg, ethacrynic acid & furosemide. Binds w/ cholestyramine.

Other Antibiotics

J01XA01 - vancomycin ; Belongs to the class of glycopeptide antibacterials. Used in the systemic treatment of infections.

Rx