Vancomycin and Lipoglycopeptide Flashcards
What is the mechanism of action of vancomycin
- inhibits gram positive cell wall biosynthesis
- binds to peptidyl side chain D-Ala D-Ala terminus before cross linking
- What mechanism is inhibited by vancomycin
- transpeptidase reaction to cross link peptidoglycan strands
- also inhibits the transglycolyation step in peptidoglycan synthesis
What is the spectrum of activity of vancomycin?
- bactericidal
- active against gram positive bacteria
What is the mechanism of resistance of VRE
- appears as a mutation of the peptidoglycan cell wall precursor
- D Ala D Ala –> D Ala D Lactate
- vancomycin cannot inhibit transpeptidase when substrate is D-Lactate due to lack of affinity
How is vancomycin administered
Parenterally and orally (only in one case)
What are the main therapeutic uses of vancomycin
- Oral vancomycin: C diff
- IV for MRSA
What are the toxic effects of vancomycin?
- Red skin rash
- potential anaphylaxis
- neprotoxicity
- ototoxicity
What are the PK of vancomycin?
- highly distributed
- 90% eliminated by glomerular filtration
What type of antibiotic is oritavancin
semisynthetic lipoglycopeptide
What is the mechanism of action of oritavancin
- inhibits transpeptidation
what is the spectrum of activity of oritavancin
broad spectrum of gram positive bacteria including MRSA
What is the mechanism of action of telavacin
- like vancomycin
- binds to the D-Ala D-Ala termius of the peptidoglycan
- inhibits transpeptidation and transglycosylation
What is the therapeutic use o f telavancin
- MRSA and gram positive infections
What type of lipoglycopeptide antibiotic is dalbavacin
- second generation
What is the mechanism of action of dalbavancin
- identical to vancomycin
- binds to D-Ala D-Ala residue on growing peptidoglycan chains and prevents transglycosylation from occuring
What is the spectrum of activity of dabalvancin
broad spectrum of gram positive bacteria including MRSA and MRSE
What is the difference between the half lives of Dalbavacin and Oritavancin differ from Vancomycin and Telavancin
- half lives are longer (200 vs 10)
- oritavancin has longest half life: 245 h
