Vancobac

Indications

• Injection: serious infections caused by certain bacteria, including MRSA (Staphylococcus that resists many antibiotics). Examples are blood infections, infection of the heart valves (endocarditis), bone and joint infections, pneumonia and severe skin infections.
• Injection: prevention of infection before some operations in people allergic to Penicillin.
• Capsules (by mouth): diarrhoea caused by Clostridioides difficile, a bowel infection that can follow antibiotic use.

When taken by mouth, Vancomycin stays in the gut and does not treat infections elsewhere in the body.

How It Works

Vancomycin is a glycopeptide antibiotic. It stops bacteria from building their outer wall, so they cannot survive. It works only against certain types of bacteria.

Dosage and Administration

Injection: given by a doctor or nurse in hospital as a slow drip into a vein, usually over at least 60 minutes. The dose depends on body weight, kidney function and blood level tests, as prescribed.

Capsules for Clostridioides difficile, adults: usually 125 mg four times a day for 10 days, as prescribed. Swallow whole.

Children: only as prescribed, based on body weight.

Interactions

• Other medicines that can harm the kidneys or hearing, such as Gentamicin, Amikacin, Amphotericin B, Cisplatin and Furosemide: higher risk of kidney damage or hearing loss.
• Piperacillin with Tazobactam: may increase the risk of kidney problems.
• Anaesthetics: higher risk of flushing and low blood pressure during the drip.

Contraindications

• Allergy to Vancomycin

Side Effects

Injection: flushing and a red rash on the upper body with itching or low blood pressure if the drip runs too fast; pain or swelling at the drip site; kidney problems; ringing in the ears or hearing loss; low white blood cells; fever.

Capsules: nausea, stomach pain and a bad taste.

Get medical help at once (tell the nurse during a drip) for trouble breathing, chest tightness or swelling of the face; a widespread blistering or peeling rash with fever; much less urine than usual; new ringing in the ears or hearing changes; or new severe diarrhoea.

Pregnancy and Lactation

Vancomycin is used in pregnancy only when clearly needed, with blood levels checked. It passes into breast milk, but little is absorbed by the baby; the doctor decides whether to continue breastfeeding.

Precautions and Warnings

• Blood levels and kidney tests are checked during injection treatment.
• Hearing may be checked in long courses, older people and kidney disease.
• Take extra care in people with kidney problems or past hearing loss.
• Complete the full course.

Overdose

Overdose is treated in hospital with supportive care and close watch on kidney function. Some types of dialysis can remove part of the medicine.

Therapeutic Class

Antibiotic (glycopeptide).

Storage

Store unopened vials and capsules below 30°C, away from light and out of the reach of children, or as stated on the pack. Once mixed, the solution is kept as the pack directs (often in a fridge at 2 to 8°C for a limited time).