Background:

Vancomycin is an antibiotic for the treatment of bacterial infections.

Vancomycin is a large glycopeptide compound with a molecular weight of 1450 Da[1]. Vancomycin is a unique glycopeptide structurally unrelated to any currently available antibiotic. It also has a unique mode of action inhibiting the second stage of cell wall synthesis of susceptible bacteria. Vancomycin is active against a large number of species of Gram-positive bacteria, such as Staphylococcus aureus, Staph. epidermidis, Str. agalactiae, Str. bovis, Str. mutans, viridans streptococci, enterococci[2].

Vancomycin is administered intravenously, with a standard infusion time of at least 1 h, to minimize infusion-related adverse effects. Subjects with normal creatinine clearance, vancomycin has an α-distribution phase of 30 min to 1 h and a β-elimination half-life of 6-12 h. The volume of distribution is 0.4-1 L/kg. The binding of vancomycin to protein ranges from 10% to 50%. Factors that affect the overall activity of vancomycin include its tissue distribution, inoculum size, and protein-binding effects[1]. Vancomycin treatment of infected mice is associated with improved clinical, diarrhea, and histopathology scores and survival during treatment[3].

[1]. Rybak MJ, et al. The pharmacokinetic and pharmacodynamic properties of vancomycin. Clin Infect Dis. 2006 Jan 1;42 Suppl 1:S35-9. [2]. Watanakunakorn C, et al. Mode of action and in-vitro activity of vancomycin. J Antimicrob Chemother. 1984 Dec;14 Suppl D:7-18. [3]. Warren CA, et al. Vancomycin treatment’s association with delayed intestinal tissue injury, clostridial overgrowth, and recurrence of Clostridium difficile infection in mice. Antimicrob Agents Chemother. 2013 Feb;57(2):689-96.