Vancomycin

Vancomycin is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

  • Vancomycin (usual starting dose is 15 mg/kg IV q12h) is a glycopeptide antibiotic that interferes with cell wall synthesis by binding to D-alanyl-D-alanine precursors that are critical for peptidoglycan cross-linking in most gram-positive bacterial cell walls. Vancomycin is bactericidal for staphylococci but bacteriostatic for enterococci.
  • Vancomycin-resistant Enterococcus faecium (VRE) and vancomycin intermediate-resistant S. aureus (VISA) present increasing treatment challenges. Vancomycin-resistant 
S. aureus has been reported but remains rare.

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General Principles

  • Vancomycin (usual starting dose is 15 mg/kg IV q12h) is a glycopeptide antibiotic that interferes with cell wall synthesis by binding to D-alanyl-D-alanine precursors that are critical for peptidoglycan cross-linking in most gram-positive bacterial cell walls. Vancomycin is bactericidal for staphylococci but bacteriostatic for enterococci.
  • Vancomycin-resistant Enterococcus faecium (VRE) and vancomycin intermediate-resistant S. aureus (VISA) present increasing treatment challenges. Vancomycin-resistant 
S. aureus has been reported but remains rare.

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