Antibacterial drug vancomycin

Cardiovascular In a prospective comparison of vancomycin with other intravenous antibacterial drugs, vancomycin was not associated with increased rates of phlebitis, but was associated with increased numbers of venepunctures and time spent restarting peripheral intravenous catheters [53 ]. 

Antibacterial drugs that affect cell wall synthesis include two large femilies,the penicillins and cephalosporins, and two individual drugs, bacitracin and vancomycin. 

Antibacterial drugs that inhibit cell wall synthesis penicillins, cephalosporins and vancomycin... 

Antibacterial drugs Some intravitreal antibacterial drugs, such as aminoglycosides, are toxic to the retina, even at low doses. Vancomycin is non-toxic at the recommended dose, but the concentrations achieved in a silicon-filled eye were unpredictable. 

Teicoplanin is a glycopeptide antibiotic that is very similar to vancomycin in mechanism of action and antibacterial spectrum. Unlike vancomycin, it can be given intramuscularly as well as intravenously. Teicoplanin has a long half-life (45-70 hours), permitting once-daily dosing. This drug is available in Europe but has not been approved for use in the United States. 

A randomised, crossover study in 9 healthy subjects found that infusions of vancomycin 500 mg and piperacillin 3 g with tazobactam 375 mg had little or no effect on the pharmacokinetics of any of the antibacterials, except that the piperacillin AUC was slightly raised, by about 7%. It was concluded that no dosage adjustments are needed if these drugs are given together. ... 

Colestyramine binds with vancomycin within the gut, thereby reducing its biological activity (about tenfold according to in vitro studies). The combination of vancomycin and colestyramine used to be used in antibacterial-associated colitis (now no longer recommended) and to overcome this interaction it was suggested that a vancomycin dosage of 2 g daily should be used, and that administration of the vancomycin and colestyramine should be separated as much as possible to minimise their admixture in the gut. It is usually recommended that other drugs should be taken 1 hour before or 4 to 6 hours after colestyramine. 

An elderly woman who had been treated with low-dose methotrexate 5 mg weekly and loxoprofen for one month developed acute pyelonephritis. Intravenous eefotiam was started, and on day 7 she developed severe watery diarrhoea. Analysis showed pancytopenia and Clostridium difficile infection. Methotrexate and cefotiam were stopped, and vancomycin started, and the patient reeovered. It was suggested that the combination of the antineoplastic drug and antibacterial increased the risk of Clostridium difficile diarrhoea. In addition, the NSAID (see Methotrexate + NSAIDs , p.649) and renal impairment from the pyelonephritis could have eontrib-uted to the methotrexate toxicity. This appears to be an isolated ease, and any interaetion with cefotiam is not established. 

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