Glycopeptides

Question 1

What are glycopeptides active against?

Answer 1

• Gram positive bacteria only (including MRSA)

- Narrow spectrum

Question 2

What are glycopeptides used for?

Answer 2

• Antibiotic-associated colitis

- MRSA

Question 3

What are some examples of glycopeptides?

Answer 3

• Teicoplanin
• Vancomycin
• Televancin (only used in HAP when everything else is unsuitable)

Question 4

How does vancomycin need to be given?

Answer 4

• Parenterally for serious infections

Question 5

Vancomycin has a narrow TI, how do you need to monitor plasma concs?

Answer 5

• After 3 or 4 doses and after dose change
• Renal impairment - earlier and regular monitoring - reduce dose
• Trough level - 10-15mg/ml

Question 6

What are the side effects of vancomycin?

Answer 6

• Nephrotoxicity - avoid: ciclosporin, tacrolimus, vancomycin, gentamicin
• Ototoxicity - avoid: loop diuretics and cisplatin
• Red man syndrome
• Blood dyscrasias
• Skin disorders
• Thrombophlebitis - pain and inlflammation of veins at infusion site