Glycopeptides

Question 1

Example of a Glycopeptide

Answer 1

Vancomycin

Question 2

How does Vancomycin work?

Answer 2

Vancomycin inhibits growth and cross-linking of peptidoglycan chains, inhibiting synthesis of the cell wall of Gram-positive bacteria. It therefore has specific activity against Gram-positive aerobic and anaerobic bacteria and is inactive against most Gram-negative bacteria, which have a different (lipopolysaccharide) cell wall structure. Bacterial resistance to vancomycin is increasingly reported. One mechanism is modification of cell wall structure to prevent vancomycin binding.

Question 3

Indications for Vancomycin

Answer 3

Treatment of Gram-positive infection, e.g. endocarditis, where infection is severe and/or penicillins cannot be used due to resistance (e.g. meticillin-resistant Staphylococcus aureus [MRSA]) or allergy.

Treatment of antibiotic-associated colitis caused by Clostridium difficile infection (usually second-line where metronidazole is ineffective or poorly tolerated).

Question 4

Elimination of Vancomycin

Answer 4

Renal