Vancorus, powder and oral intake 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 has been noted.

Indications

Infectious inflammatory diseases of severe course, caused by pathogens sensitive to vancomycin (when ineffective or intolerant 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 hydrochloride form) 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 min.

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 intakes, for children – 40 mg/kg in 3-4 intakes.

The maximum daily dose for adults when administered by IV 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 concomitant 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. Colestiramine reduces 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. Vancomycin infusion is possible at least 60 min before their administration.

Special Instructions

The use in the II-III trimester of pregnancy is possible only for “vital” indications. When administering to premature and normal neonates, monitoring of serum concentrations is desirable.

The incidence of side effects increases when concomitantly administered with general anesthetics, so vancomycin is better administered before general anesthesia. Audiograms and renal function tests (urinalysis, creatinine and urea nitrogen values) are necessary during treatment.

It is desirable to determine vancomycin serum concentrations (in renal failure, in patients over 60 years). Maximum concentrations should not exceed 40 µg/ml and minimum concentrations should not exceed 10 µg/ml. Concentrations above 80 µg/ml are considered toxic.

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 trunk, hands, palpitations, nausea, vomiting, chills, fever, fainting.

Urinary system disorders: urinary disorders, interstitial nephritis.

CNS disorders: decreased hearing, ringing and “congestion” sensation in the ears.

Hematopoietic system: neutropenia, eosinophilia, thrombocytopenia, agranulocytosis.

Allergic reactions: skin 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.

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