Vancomycin Flashcards
What ABX is pretty much the “gold-standard” for treating any kind of osteomyelitis, endocarditis, or Nosocomial Pneumonia?
Vancomycin
What G+ organisms will Vancomycin cover?
ALL G+
except VRE, AKA vancomycin resistant enterococcus
What is Vancomycin’s mechanism of action?
-Vancomycin inhibits the biosynthesis of peptidoglycan polymers during cell wall formation (complexes with D-ALANYL-D-ALANINE precursor).
Is Vancomycin bactericidal or bacteriostatic?
BACTERIOCIDAL
T/F
Vancomycin exhibits Post Antibiotic Effect?
TRUE
-After exposure to inhibitory concentrations of vancomycin, continued killing occurs (2 hrs).
Why is Vancomycin almost always given IV?
When is it given orally?
Poorly absorbed in GI Tract
C. Difficile infections
T/F
Vancomycin distributes to CSF only with inflammation.
T/F
Vancomycin almost entirely unchanged via glomerular filtration.
TRUE
TRUE
Is there a reason Linezolid should be used over Vancomycin in the case of pneumonias?
NO–data suggesting linezolid penetrated lungs better than Vanc was smoke-and-mirrors
What are the common hematological adverse reaction to Vancomycin?
Eosinophelia
Thrombocytopenia
Neutropenia
What are the common hypersensitive adverse reaction to Vancomycin?
What are the common Local adverse reaction to Vancomycin?
Maculopapular Rash
Thrombophlebitis
Which adverse reactions to Vancomycin are related to dosage?
Ototoxicity (peaks)
Nephrotoxicity (troughs)
Which adverse reactions to Vancomycin are related to speed of infusion?
RED MAN SYNDROME
What bugs are covered by Vancomycin?
ALL G+ (Staph, Strep, Entero)
Clostridium
Bacillus Anthracis
Crynebacteria
Does Vancomycin cover any G– Species?
NO
What are indications that Vancomycin should be used?
Serious B-lactam resistant G+ infections
Patients seriously allergic to B-lactams with G+ infections
Recurrent C. Diff
Metronidazole resistant C. Diff
What ABX should be used for routine surgery prophylaxis?
Cefazolin
Should Vanc dosing be adjusted for pts. with renal insufficiency?
YES
Should Vancomycin be used for routine eradication of MRSA?
NO
will kill MRSA but don’t use routine because we want to conserve it as not to develop resistance
When should trough values be ordered?
RIGHT BEFORE NEXT DOSE IS DUE
What is first-line therapy for C. diff?
What is second-line therapy for C. diff?
Metronidazole
Vancomycin
Do we need to check Vancomycin levels if C. difficile patient has been drinking the IV for treatment (because oral tablet is more expensive)?
NO (Vanc does not get out of gut lumen)
