Vancomycin is the name given to a glycopeptide antibiotic. It is used when other antibiotics are no longer effective due to bacterial resistance.
What is vancomycin?
Vancomycin is the name given to a glycopeptide antibiotic. Vancomycin is a glycopeptide antibiotic used to treat Gram-positive bacteria. It has the status of a reserve antibiotic and is administered for the treatment of endocarditis or meningitis. The development of vancomycin took place in the 1950s. The manufacturers obtained the drug from cultures of the bacterial species Amycolatopsis orientalis. In 1959, the glycopeptide antibiotic entered the market. However, it took until 1980 before the active ingredient was successfully administered against staphylococcus bacteria in which there was resistance to other antibiotics. Staphylococci are hospital germs responsible for nosocomial infections. Thus, vancomycin is one of the third-line antibiotics. It is usually used only when other antibiotics are no longer effective because of staphylococcal resistance.
Pharmacologic action
Together with teicoplanin, vancomycin represents the group of glycopeptide antibiotics. As a result, it has the property of inhibiting the cell wall protein murein of bacteria. Murein is extremely important for bacteria. By inhibiting it, vancomycin exerts bactericidal effects that lead to the destruction of the bacteria after a certain time. However, the duration of action of vancomycin is much shorter than that of teicoplanin. Another disadvantage of the drug is that it is poorly tolerated by some patients. Because vancomycin interferes with the cell wall structure of the bacteria, causing the germs to die, the only thing left for the immune system to do is to eliminate the pathogens from the body. As a result, the patients quickly feel better again. The advantage of vancomycin is that glycopeptide antibiotics still work well against most types of bacteria. These primarily include staphylococci such as the hospital germ Staphylococcus aureus and the bacterial species enterococci. In recent years, however, some strains of bacteria have also developed resistance to vancomycin, posing further problems for the medical community. When vancomycin is taken orally, the drug does not pass from the intestine into the blood. Thus, the intestinal wall cannot be overcome by the antibiotic. This can be useful when treating local intestinal infections. To achieve an effect of vancomycin in the body tissues, it is necessary to inject the active substance directly into the bloodstream. Excretion of the antibiotic from the body occurs through the urine.
Medical application and use
Vancomycin is usually administered for bacterial infections against which other antibiotics, such as cephalosporins, macrolide antibiotics, or penicillins, are no longer effective because the pathogens are resistant to them or the patient suffers from a severe allergy to conventional antibiotics. The indications for vancomycin include bacterial blood poisoning (sepsis), endocarditis (inflammation of the inner lining of the heart), pneumonia, soft tissue infections, inflammation of the bone marrow and periosteum, and bacterial joint inflammation. In addition, vancomycin is used in surgical procedures. The drug is used to prevent bacterial infections of the heart, joints, bones and blood vessels. Vancomycin is only taken as a capsule for the treatment of severe intestinal infections. These are mostly pseudomembranous enterocolitis. This often results from treatment with other antibiotics. In addition, vancomycin is administered by infusion. In the case of severe bacterial disease, the use of vancomycin is possible even in babies. Vancomycin is subject to prescription. Therefore, the drug is available only by presenting a doctor’s prescription at the pharmacy.
Risks and side effects
Vancomycin can cause adverse side effects in about 1 to 10 percent of all patients. Thus, it is not uncommon for allergic reactions or gastrointestinal problems to occur.Other side effects may include skin rash, itching, damage to the kidneys, inflammation of the mucous membranes, ringing in the ears, nausea, vomiting, chills, fever, inflammation of the blood vessels, low blood pressure or shock. In the worst case, there is even a risk of cardiac arrest. Rarely, an overgrowth of fungi in the body is also within the realm of possibility. Vancomycin must not be administered at all if the patient suffers from hypersensitivity to the substance. If there is severe hearing damage, only infusion treatment with vancomycin is possible if the patient’s life is in danger. In pregnancy, the antibiotic should only be used if the risks and benefits have been carefully weighed up by the doctor beforehand. Vancomycin can also be used during breastfeeding only if there is no other therapeutic option, as the drug passes into breast milk and can cause health problems in the baby. There is a risk of drug interactions if vancomycin is taken at the same time as other medications. For example, if the antibiotic is given with aminoglycosides, it may have adverse effects on the ears and kidneys. In addition, anesthetics have a reinforcing effect on allergies to vancomycin, which are manifested by a drop in blood pressure or changes in the skin. The administration of vancomycin has no negative effects on responsiveness. Thus, the patient can participate in road traffic without any problems. Likewise, the operation of heavy machinery is possible.
