Vancomycin, lyophilizate and oral administration 0.5 g

An antibiotic of the glycopeptide group.

Vancomycin has a bactericidal effect.

Disrupts cell wall synthesis, cytoplasmic membrane permeability and RNA synthesis in bacteria.

Active against Gram-positive bacteria: Staphylococcus spp. (including penicillinase-producing and methicillin-resistant strains), Streptococcus spp, Enterococcus spp., Corynebacterium spp., Listeria spp., Actinomyces spp., Clostridium spp. (including Clostridium difficile). No cross-resistance with antibiotics of other groups was noted.

Indications

Infectious-inflammatory diseases of severe course, caused by pathogens sensitive to vancomycin (with ineffectiveness or intolerance to penicillins and cephalosporins): sepsis, endocarditis, pneumonia, lung abscess, meningitis, osteomyelitis.

Pseudomembranous colitis caused by Clostridium difficile.

Active ingredient

Composition

1 vial contains vancomycin (in the form of hydrochloride) 0.5 g.

How to take, the dosage

Injected by IV (intravenous) drip. In adults, 500 mg every 6 hours or 1 g every 12 hours.

In order to avoid collaptoid reactions, the duration of infusion should be at least 60 minutes.

In children, 40 mg/kg/day, each dose should be administered for at least 60 minutes.

In patients with impaired renal excretory function the dose is reduced taking into account the CK values.

Depending on the etiology of the disease, Vancomycin can be taken orally.

For adults the daily dose is 0.5-2 g in 3-4 doses, for children – 40 mg/kg in 3-4 doses.

The maximum daily dose for adults when given by injection is 3-4 g.

Interaction

In concomitant administration with local anesthetics in children erythematous rashes and facial skin hyperemia may appear, in adults – intracardiac conduction disorders.

The simultaneous administration with nephro- and ototoxic drugs (aminoglycosides, amphotericin B, ASA or other salicylates, bacitracin, bumetanide, capreomycin, carmustine, paramomycin, cyclosporine, “loop” diuretics, polymyxine B, cisplatin, etacrynic acid) is not recommended.

Colestyramine decreases efficacy.

The antihistamines, meclosine, phenothiazines, thioxanthenes may mask the symptoms of ototoxic effects of vancomycin (tinnitus, vertigo).

General anesthetics and vecuronium bromide – risk of BP decrease or development of neuromuscular block.

Infusion of vancomycin is possible at least 60 min before their administration.

Contraindications

Hearing nerve neuritis, first trimester of pregnancy, marked renal dysfunction, hypersensitivity to vancomycin.

Side effects

In case of rapid IV administration, “red neck syndrome” associated with histamine release may develop: erythema, skin rash, redness of the face, neck, upper torso, arms, palpitations, nausea, vomiting, chills, fever, fainting.

Urinary system disorders:disordered urination, interstitial nephritis.

CNS side:decreased hearing, ringing and a feeling of “blockage” in the ears.

Hematopoietic system disorders: neutropenia, eosinophilia, thrombocytopenia, agranulocytosis.

Allergic reactions:cutaneous itching, urticaria, anaphylactic reactions.

Overdose

Symptoms:increased severity of side effects.

Treatment:symptomatic in combination with hemoperfusion and hemofiltration.

Pregnancy use

The use in the first trimester of pregnancy is contraindicated due to the risk of nephro- and ototoxicity.

The use of vancomycin in II and III trimesters is possible only for vital indications.

Breastfeeding should be discontinued if use during lactation is necessary.