VANCOMYCIN HYDROCHLORIDE

Vancocin CP

Reviewed by NICU and Pharmacy
November 2011
Administration Newborn Drug Protocol Index Newborn Services Home Page

 

Dose and Administration1

 

 

Postmenstrual Age
(weeks)
Dose
(mg/kg/dose)
Dosing Interval
(hours)
< 28 15 24
29 to 35 15 12
36 15 8

Contraindications2,3

Precautions3,4

Clinical Pharmacology2,5

Vancomycin is an glycopeptide antimicrobial, chemically unrelated to any other antimicrobial agent. Acting at a site different from other penicillins, vancomycin inhibits bacterial cell wall synthesis and may also cause secondary damage to the cytoplasmic membrane and inhibition of bacterial RNA synthesis.

It is bactericidal against many gram-positive organisms. In vitro susceptibility includes Listeria monocytogenes, and species of Lactobacillus, Actinomyces , Clostridium, and Bacillus.

Gram-negative bacteria, mycobacteria and fungi are resistant.

There are increasing reports of high-level acquired vancomycin resistance amongst enterococci with apparent resistance transfer to other Gram-positive organisms notably Staph.aureus.8 Organisms with high-level resistance to vancomycin demonstrate cross-resistance to teicoplanin. Low-level resistance in enterococci to vancomycin does not appear to be transferable to teicoplanin; however low-level resistance to staphylococcus strains shows cross-resistance to teicoplanin.

Vancomycin is administered intravenously and is poorly absorbed when given orally. There is no apparent metabolism and it is excreted unchanged by glomerular filtration. The mean elimination half-life from plasma is 4 to 6 hours in adults with normal renal function. Protein binding is approximately 55%. It does not readily diffuse across the meninges into the cerebrospinal fluid.

Possible Adverse Effects2

Drug Interactions4

The following are possible interactions with drugs commonly used in NICU:

Special Considerations2,7