How vancomycin works
Vancomycin is an active substance from the group of glycopeptide antibiotics. It has a bactericidal effect against gram-positive pathogens and is used when other antibiotics are not sufficiently effective.
The human immune system uses various mechanisms to protect the body against the implantation and spread of pathogens. As a rule, people do not even notice when their immune system is active, or they only experience mild symptoms as a result of infection with a pathogen.
Sometimes, however, the body’s defenses are not immediately able to successfully combat a pathogen. The symptoms then become more severe. If the body can no longer cope with the pathogens, medication can support the immune response.
These drugs include the antibiotic vancomycin. It interferes with the cell wall structure of pathogenic bacteria, causing them to die. This means that the immune system only has to deal with excreting the bacteria and the symptoms of the disease usually improve quickly.
Vancomycin is only effective against a certain type of bacteria (so-called “gram-positive” bacteria). The doctor must therefore determine in advance which type of bacteria is to be combated.
Absorption, breakdown and excretion
However, if the antibiotic is to be effective in the body tissue, it must be introduced directly into the bloodstream. After distribution, vancomycin is excreted unchanged in the urine. Usually, half of the active substance has left the body after four to six hours. However, if kidney function is impaired, this time can increase to up to 7.5 days.
When is vancomycin used?
Vancomycin is administered by infusion in the following cases:
- severe bacterial diseases such as inflammation of the meninges (meningitis), the inner lining of the heart, the bones and joints or the skin and soft tissues
In the following cases, vancomycin is administered orally, i.e. by mouth:
- severe Clostridium difficile infection (CDI)
The bacterium Clostridium difficile can cause diarrhea, which can be fatal in severe cases.
How vancomycin is used
Depending on the clinical picture, vancomycin is either swallowed in the form of a solution or capsule (for inflammation in the intestine) or administered directly into the bloodstream in the form of an infusion (for inflammation in body tissue).
When taken by mouth, the dosage is between 500 milligrams and two grams per day, which should be divided into three to four individual doses. The duration of treatment should be around seven to ten days and is determined by the doctor depending on the severity of the disease.
Patients with renal dysfunction, children, adolescents and elderly patients receive a reduced dose.
What are the side effects of vancomycin?
Occasionally, i.e. in one to ten percent of those treated, vancomycin causes side effects in the form of gastrointestinal complaints or allergic reactions (redneck syndrome).
Rarely, i.e. in one in a hundred patients, blood count changes, nausea, chills and pain in the shoulder or back muscles occur.
Very rarely, taking the antibiotic can have a damaging effect on the inner ear (ototoxic effect) or the kidneys (nephrotoxic effect).
What should be considered when taking vancomycin?
Contraindications
Vancomycin must not be used in the following cases
- known hypersensitivity to the active substance or any of the other ingredients of the medicine
Particular caution is required in case of renal dysfunction or hearing impairment.
Interactions
The simultaneous administration of medications that can have a damaging effect on the inner ear or kidneys should be avoided as far as possible. The risk of such side effects depends on the dose and is particularly high in the case of impaired kidney function (greatly delayed excretion of vancomycin).
Vancomycin can increase the effect of muscle relaxants.
Ability to drive and operate machinery
Vancomycin has practically no influence on the ability to react. Therefore, you may actively participate in traffic and operate heavy machinery after using the antibiotic.
Age restrictions
Medication containing vancomycin may also be used in infants in the case of severe bacterial diseases.
Pregnancy and breastfeeding
The antibiotic can reach the unborn child via the placenta. To date, there is very little experience of its use during pregnancy, which is why it is advisable to use better-proven alternatives in the event of a bacterial disease.
During breastfeeding, the active ingredient reaches the baby through breast milk. Experts therefore recommend using other antibiotics if possible.
However, if no other treatment is possible, vancomycin can also be used during pregnancy and breastfeeding after an individual risk-benefit assessment by a doctor.
How to obtain medication with vancomycin
Vancomycin medication is only available on prescription in Germany, Austria and Switzerland.
