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Pediatric Clinics of North America Feb 1983
Review
Topics: Adolescent; Adult; Bacterial Infections; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Kinetics; Vancomycin
PubMed: 6338468
DOI: 10.1016/s0031-3955(16)34318-8 -
American Journal of Health-system... May 2020
Topics: Anti-Bacterial Agents; Drug Monitoring; Humans; Practice Guidelines as Topic; Vancomycin
PubMed: 32426842
DOI: 10.1093/ajhp/zxaa076 -
American Journal of Kidney Diseases :... Aug 1986
Review
Topics: Aminoglycosides; Animals; Anti-Bacterial Agents; Bacterial Infections; Drug Therapy, Combination; Half-Life; Humans; Kidney; Kidney Diseases; Kidney Function Tests; Kinetics; Nephrectomy; Renal Dialysis; Vancomycin
PubMed: 3526874
DOI: 10.1016/s0272-6386(86)80116-0 -
The Journal of Antimicrobial... Dec 1984
Review
Topics: Clostridium; Cross Infection; Deafness; Drug Administration Schedule; Drug Resistance, Microbial; Drug Therapy, Combination; Humans; Infusions, Parenteral; Vancomycin
PubMed: 6394568
DOI: No ID Found -
Expert Review of Anti-infective Therapy Jun 2007The recognition of the shortcomings of vancomycin as an antistaphylococcal agent, together with the burgeoning availability of alternative effective antistaphylococcal... (Review)
Review
The recognition of the shortcomings of vancomycin as an antistaphylococcal agent, together with the burgeoning availability of alternative effective antistaphylococcal antibiotics, has led to a reassessment of the role of this glycopeptide antimicrobial in clinical therapeutics. Evidence indicates that vancomycin is inferior to semisynthetic penicillins in the treatment of infections due to methicillin-susceptible Staphylococcus aureus. Additional evidence suggests that vancomycin may be inferior to some comparator agents in the treatment of infections due to methicillin-resistant S. aureus (MRSA). While high-level resistance remains rare, data from some centers suggest an evolutionary change in S. aureus, evidenced by reduced susceptibility to vancomycin. This, together with the problem of heteroresistance to vancomycin, as well as poor tissue penetration after its systemic administration, presents potential obstacles to the successful therapy of S. aureus infections with this glycopeptide. While it has been suggested that these problems may be overcome by administration of vancomycin in much higher doses, the efficacy and safety of this approach remains to be determined and will require randomized clinical trials for its demonstration. A number of novel agents with activity against MRSA have been introduced to clinical practice in the last 2 years and others are still in the investigational stage. Despite the fact that these newer agents have been compared with vancomycin in trials only designed to demonstrate noninferiority, some potential evidence of superiority over vancomycin has emerged. While the relative roles of each of these newer agents and vancomycin can only be determined definitively by performance of adequately powered randomized clinical trials, current evidence suggests that vancomycin may be an inferior therapeutic agent.
Topics: Anti-Bacterial Agents; Clinical Trials as Topic; Drug Resistance, Bacterial; Humans; Staphylococcal Infections; Staphylococcus aureus; Vancomycin
PubMed: 17547504
DOI: 10.1586/14787210.5.3.393 -
The American Journal of Medicine Feb 2010Vancomycin-associated nephrotoxicity was reported in 0% to 5% of patients in the 1980s. This has been confirmed by numerous clinical trials comparing novel... (Review)
Review
Vancomycin-associated nephrotoxicity was reported in 0% to 5% of patients in the 1980s. This has been confirmed by numerous clinical trials comparing novel anti-methicillin-resistant Staphylococcus aureus agents with vancomycin at the Food and Drug Administration-approved dosage of 1 g every 12 hours. Treatment failures of vancomycin in patients with methicillin-resistant S. aureus infections have been reported despite in vitro susceptibility. These failures have led to the use of vancomycin doses higher than those approved by the Food and Drug Administration. Higher doses are being administered to achieve goal vancomycin trough concentrations of 10 to 20 microg/mL recommended by several clinical practice guidelines endorsed by the Infectious Diseases Society of America. Recent studies suggest that increased rates of nephrotoxicity are associated with aggressive vancomycin dosing. These increased rates are confounded by concomitant nephrotoxins, renal insufficiency, or changing hemodynamics. These studies also have demonstrated that vancomycin's nephrotoxicity risk is minimal in patients without risk factors for nephrotoxicity. Clinicians unwilling to dose vancomycin in accordance with clinical practice guidelines should use an alternative agent because inadequate dosing increases the likelihood of selecting heteroresistant methicillin-resistant S. aureus isolates.
Topics: Anti-Bacterial Agents; Dose-Response Relationship, Drug; Drug Monitoring; Humans; Kidney Diseases; Methicillin-Resistant Staphylococcus aureus; Staphylococcal Infections; Treatment Outcome; Vancomycin
PubMed: 20103028
DOI: 10.1016/j.amjmed.2009.05.031 -
Mayo Clinic Proceedings Feb 1983Vancomycin is a narrow-spectrum bactericidal antistaphylococcal antibiotic that was introduced in 1956 because of its efficacy against resistant penicillinase-producing...
Vancomycin is a narrow-spectrum bactericidal antistaphylococcal antibiotic that was introduced in 1956 because of its efficacy against resistant penicillinase-producing staphylococci. It was effective for serious staphylococcal infections for which no satisfactory alternative to penicillin G was available at the time. When methicillin and the other semisynthetic penicillins and the cephalosporins were introduced, the role of vancomycin was relegated to the alternative therapy of choice when the penicillins and the cephalosporins could not be used. In the future, vancomycin may be used more frequently in (1) methicillin-resistant Staphylococcus aureus infections, (2) streptococcal endocarditis in conjunction with an aminoglycoside in patients intolerant to penicillin or ampicillin, (3) infections associated with prosthetic devices caused by organisms with multiple antibiotic resistance, and (4) antibiotic-induced enterocolitis associated with Clostridium difficile.
Topics: Bacterial Infections; Dose-Response Relationship, Drug; Humans; Kinetics; Microbial Sensitivity Tests; Staphylococcal Infections; Vancomycin
PubMed: 6823162
DOI: No ID Found -
Mayo Clinic Proceedings Oct 1987Vancomycin is a narrow-spectrum bactericidal antibiotic used primarily for treatment of serious staphylococcal infections. It is the alternative therapy of choice when...
Vancomycin is a narrow-spectrum bactericidal antibiotic used primarily for treatment of serious staphylococcal infections. It is the alternative therapy of choice when the penicillins and cephalosporins cannot be used. Vancomycin is also used in (1) methicillin-resistant Staphylococcus aureus infections; (2) streptococcal endocarditis in conjunction with an aminoglycoside in patients intolerant of penicillin or ampicillin; (3) infections, including those involving prosthetic devices, caused by gram-positive organisms with multiple antibiotic resistance; (4) antibiotic-induced enterocolitis caused by Clostridium difficile; and (5) prophylaxis for endocarditis in patients who are at risk and cannot tolerate a penicillin, cephalosporin, or erythromycin. The major toxic effect associated with the use of vancomycin is ototoxicity, which may develop when serum levels exceed 30 micrograms/ml.
Topics: Bacterial Infections; Humans; Microbial Sensitivity Tests; Vancomycin
PubMed: 3657307
DOI: 10.1016/s0025-6196(12)65046-0 -
Angewandte Chemie (International Ed. in... Feb 2003Antibiotics are precious resources in the fight to combat bacterial infections caused by pathogenic organisms. Vancomycin is one of the antibiotics of last resort in the... (Review)
Review
Antibiotics are precious resources in the fight to combat bacterial infections caused by pathogenic organisms. Vancomycin is one of the antibiotics of last resort in the treatment of life-threatening infections by gram-positive bacteria. The rules by which nature assembles the glycopeptide (vancomycin) and lipoglycopeptide (teicoplanin) antibiotics are becoming elucidated and verified: first amino acids are synthesized, then joined together and cross-linked. This knowledge opens up approaches for reprogramming strategies at the level of altered monomers, swapped assembly lines, and different post-assembly tailoring enzymes.
Topics: Anti-Bacterial Agents; Bacteria; Drug Resistance, Bacterial; Gene Expression Regulation, Bacterial; Glycosylation; Vancomycin
PubMed: 12596194
DOI: 10.1002/anie.200390202 -
Critical Care Clinics Apr 2008Vancomycin has been used for decades to treat serious systemic gram positive infections. Extensive use over time has demonstrated vancomycin is not nephrotoxic even when... (Review)
Review
Vancomycin has been used for decades to treat serious systemic gram positive infections. Extensive use over time has demonstrated vancomycin is not nephrotoxic even when used in high dosage, i.e., twice the usual dose. Since vancomycin is not nephrotoxic, there is no rationale for dosing vancomycin based on serum vancomycin levels. Since vancomycin is eliminated by GFR, vancomycin dosing should be based on creatinine clearance. Vancomycin obeys "concentration dependent" kinetics and higher than usual doses may be useful in some infections (eg, osteomyelitis). Widespread vancomycin use has resulted in increased VRE prevalence worldwide. Among staphylococci, vancomycin induced cell wall thickening results in "permeability mediated" resistance to vancomycin, as well as other anti-staphylococcal antibiotics. "Permeability mediated" resistance accounts for the common clinical observation that MRSA infections treated with vancomycin often resolve slowly or not at all. Other effective MRSA antibiotics are available (eg, linezolid, daptomycin, minocycline, or tigecycline) and are more reliably effective, do not increase staphylococcal resistance or increase VRE prevalence.
Topics: Anti-Bacterial Agents; Critical Care; Gram-Positive Bacteria; Gram-Positive Bacterial Infections; Humans; Methicillin Resistance; Staphylococcal Infections; Vancomycin
PubMed: 18361953
DOI: 10.1016/j.ccc.2007.12.012