Generic Name

Vancomycin

• Pregnancy Category C

Dosing & Formulations

• Skin and soft tissue infections: 30 mg/kg/day IV divided in 2 doses
• p.o. formulation for C. Diff

Mechanism of Action

• Inhibits synthesis of the bacterial cell wall by forming noncovalent complexes with precursors of bacterial peptidoglycan
• Covers gram positives (including MRSA and Enterococcus spp.

Indications

• IV: skin and soft tissue infections caused by or suspected to be caused by MRSA 
• Orally used in treatment of C. Difficile

Adverse Effects

• Red man syndrome occurs with histamine release from rapid infusion (can lead to shock); not a true allergic reaction and can be prevented with slower infusion +/- pre-treatment
  with antihistamines
• Other systemic: ototoxicity (in patients with renal failure), nephrotoxicity (especially if other nephrotoxic medications (e.g. aminoglycosides), fever, neutropenia, thrombocytopenia, phlebitis
• Dermatologic: linear IgA bullous dermatosis (up to 21 days), toxic epidermal necrolysis

Other

• Excreted in breast milk