Vancomycin

Description overdue on 03.03.2013

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Antibiotic , Glycopeptide. The main component is produced by Amycolatopsis orientalis. Vancomycin has bactericidal vozdeystvie   (with the exception of enterococci - they medicament bacteriostatic). The mechanism of the antibacterial action aimed at blocking the chain synthesis in the bacterial cell wall synthesis inhibition ribonuclease permeability change bacterial cell membranes. The drug acts on staphylococci , Korinobakterii, streptococci, clostridia, enterococci, actinomycetes. Optimum efficiency is observed at pH equal to 8; decrease the effectiveness of the medicament is marked by lowering the pH to 6. The antibiotic vancomycin has an active effect on the microorganisms which are in the stage of reproduction. By the action of the drug resistant virtually all gram-negative microorganisms, protozoa, viruses , Fungi, mycobacteria. Cross-resistance between vancomycin and other antibacterial drugs not registered. Vancomycin is produced as a lyophilisate. Vancomycin tablets no longer available.

Indications:

Instructions for use of the drug Vancomycin recommends prescribers with meningitis, endocarditis , Infectious skin lesions, infections of bone,   enterocolitis , Pseudomembranous colitis (pathogen - clostridia), with lung abscess, pneumonia, infection of the joints.

Contraindications:

Vancomycin is not appointed with neuritis of the auditory nerve in the first trimester of pregnancy, intolerance of the active substance, breastfeeding. When hearing impairment, the second and third trimesters of pregnancy, renal pathology of Vancomycin used with caution, after prior consultation of experts.

Side effect:

With the rapid introduction formed postinfuzionnye reaction symptom of a "red" person (cherzmernym caused by histamine release), which manifests itself palpitations, chills, fever , Muscle spasm, flushing of the skin in the upper half of the body; anaphylactic reactions   as pruritus, rash, dyspnea, bronchospasm   and the drop in blood pressure.   The digestive tract: pseudomembranous colitis Nausea. Urinary Tract:   increased BUN and creatinine nephrotoxicity   (shown in long-term therapy, in combination with aminoglycosides); rarely recorded interstitial nephritis . Senses:   ringing in the ears, hearing loss, vertigo . Bodies of hematopoiesis: rarely formed agranulocytosis, thrombocytopenia (transient form), reversible neutropenia. Of the local reactions occurs most often rash, pain at the injection site, phlebitis Necrosis in the area of ​​administration. Perhaps the development of allergic reactions such as rash, eosinophilia, fever, nausea, fever, vasculitis , Malignant exudative erythema Lyell's syndrome .

Overdose:

Higher doses of the drug Vancomycin is accompanied by intensification of the above adverse reactions. Requires hemoperfusion, hemofiltration Symptomatic therapy.

Mode of application:

Intramuscular injection of the drug Vancomycin is accompanied by severe pain, so the drug is administered exclusively intravenously at a rate no greater than 10 mg per minute, the duration of infusion is not more than an hour. Adults administered every 6 hours at 0, 5 grams or 7, 5 mg / kg. Patients with abnormal renal system dose is calculated according to the scheme 15 mg / kg dosing is further based on CC level. The powder is diluted prior to administration of vancomycin in the solution for injection: 500 mg of antibiotic in 10 ml of water. The mixed solution was diluted in sodium chloride 0 to 9%. Treatment of pseudomembranous colitis:   into a solution 0 5-2 3-4 grams per day, the therapy is designed for 7-10 days.

Special instructions:

In the second and third trimesters of pregnancy Vancomycin administered exclusively by "vital" indications. In the treatment of infants and premature babies is mandatory control over the level of the antibiotic in the blood. Vancomycin is recommended to be administered before general anesthesia Since the frequency of side effects increases with concurrent therapy general anesthetics. Be sure to hold audiogram , Control over the work of the renal system (indicators of urea nitrogen, creatinine, urinalysis). Preferred control over blood concentrations of vancomycin. Toxic effects occur at concentrations of antibiotic 80 ug / ml. The price of the drug Vancomycin is about 200 rubles.

Drug Interactions:

The children observed erythematous rash, flushing of the skin is marked and in adults is broken intracardiac conduction   while the use of anesthetics local action. It is unacceptable simultaneous treatment of ototoxic drugs and nephrotoxic drugs (ethacrynic acid, paromomycin, an aminoglycoside, cisplatin, "Loop" diuretics , Carmustine, capreomycin, polymyxin B, bumetanide, bacitracin, salicylates, amphotericin B, aminoglikozydi, cyclosporin). Reduced efficacy observed in the treatment Vancomycin   kolestiraminom . The manifestations of ototoxicity (vertigo, tinnitus) of vancomycin in the treatment of masked phenothiazines, antihistamines, thioxanthenes, meklozin. Neuromuscular blockade and the fall in blood pressure observed in the treatment of vecuronium bromide and general anesthetics (infusion of antibiotic one hour before the possible introduction of these medications).