Drugs and Slugs

Pathetic me's blogging from the TTSH ADO office.

Vancomycin: a glycopeptide antibiotic
Target group: Gram +ve antibiotic
Mode of administration:
Intravenously for systemic infections (Vancomycin cannot cross intestinal lining
Orally for Clostridium difficile infection (Pseudomembranous colitis)

Administration of Vancomycin should be throguh slow infusion of diluted solution over at least one hour. This is to avoid complications such as thrombophlebitis and red man syndrome.

Since activity of Vancomycin is time related (duration of time where drug concentration is above MIC), trough monitoring may be useful in the administration of vancomycin (in the patient we saw, it was 1mg q5days)

Indications: Gram +ve infections unresponsive to other less toxic bacteria
1. MRSA/MRSE
2. Pseudomembranous colitis relapse or unresponsive to metronidazole

Side effects:
Common: local pain, thrombophlebitis
Rare:
1. Ototoxicity
2. Nephrotoxicity: especially in those with concurrent intake of nephrotoxins (aminoglycosides)
3. Anaphylaxis, erythema multiforme, SJS, TENS
4. Red Man Syndrome