Buy Vancomycin

• endocarditis; the drug is effective both in monotherapy and in combination with aminoglycosides for the treatment of endocarditis caused by Streptococcus viridans or Streptococcus bovis. In endocarditis caused by enterococci (for example, E. faecalis), vancomycin is effective only in combination with aminoglycosides. There is evidence that vancomycin is effective in the treatment of endocarditis caused by Corynebacterium diphtheriae. Vancomycin has been successfully used in combination with rifampicin, aminoglycosides, or both antibiotics in early Streptococcus epidermidis or Corynebacterium diphtheriae endocarditis after valve replacement. In some cases, vancomycin is indicated for the prevention of endocarditis;
• sepsis;
• bone and joint infections;
• infections of the lower respiratory tract;
• skin and soft tissue infections.

Vancomycin can also be used for infections caused by gram-positive microorganisms with hypersensitivity to penicillins; intolerance or ineffectiveness of other antibiotic therapy (including penicillins or cephalosporins); infections caused by microorganisms sensitive to vancomycin but resistant to other antimicrobials.

Vancomycin oral solution is used to treat pseudomembranous colitis.

From the side of the cardiovascular system: cardiac arrest, hot flashes, decreased blood pressure, shock (these symptoms are mainly associated with rapid infusion of the drug).

From the digestive system: nausea, pseudomembranous colitis.

From the hemopoietic system: agranulocytosis, eosinophilia, neutropenia, thrombocytopenia.

From the urinary system: interstitial nephritis, changes in laboratory parameters of kidney function, impaired renal function.

Dermatological reactions: exfoliative dermatitis, benign blistering dermatosis, pruritic dermatosis, rash.

Allergic reactions: Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria, vasculitis.

From the side of the central nervous system: vertigo, tinnitus, ototoxic effects (transient or permanent). Most cases of ototoxic reactions were observed in patients who received excessive doses of vancomycin, with a history of hearing loss or while receiving other drugs with the possible development of ototoxicity, such as aminoglycosides.

Other: chills, drug fever, anaphylactoid reactions. During or shortly after too rapid infusion of vancomycin, patients may develop anaphylactoid reactions. Rapid administration of the drug can also cause red man syndrome, redness of the upper body, or chest and back muscle pain and spasm. After the infusion is stopped, these reactions usually disappear within 20 minutes, but sometimes they can last up to several hours.

Local reactions: tissue necrosis, pain, thrombophlebitis.

• acoustic neuritis;
• kidney failure;
• hypersensitivity to the drug.
• With caution prescribe the drug for hearing loss (including history).
• Pregnancy and lactation. The drug is contraindicated for use in the first trimester of pregnancy. Appointment in the II and III trimesters is possible only for health reasons.

When using the drug Vancomycin, the recommended concentration of the solution should be no more than 5 mg / ml, and the rate of administration - no more than 10 mg / min. In patients who are indicated for fluid restriction, a solution concentration of up to 10 mg/ml can be used at an infusion rate not exceeding 10 mg/min. When using such concentrations, the likelihood of developing side effects associated with infusion increases.

For adults, the daily dose of the drug is 2 g IV (500 mg every 6 hours or 1 g every 12 hours). Each dose should be administered at a rate not exceeding 10 mg/min and over a period of at least 60 minutes. The age and presence of obesity in the patient may require a change in the recommended dose based on the determination of the concentration of vancomycin in serum.

For children, the dose is set at the rate of 10 mg / kg and administered intravenously every 6 hours. Each dose should be administered over at least 60 minutes.

For newborns, the initial dose is determined at the rate of 15 mg / kg, and then 10 mg / kg every 12 hours during the first week of their life, starting from the second week of life - every 8 hours until they reach the age of one month. Each dose should be given over at least 60 minutes. In premature infants, as a result of reduced kidney function, a significant reduction in the dose of the drug may be required.

Patients with impaired renal function should individually adjust the dose depending on the level of serum creatinine or creatinine clearance (see table). In the elderly, vancomycin has a lower clearance and a larger volume of distribution. In this group, dose selection should be based on regularly monitored serum vancomycin concentrations. In case of impaired renal function in the elderly, a significant reduction in the dose of the drug may be required.

Patients with anuria should be given an initial dose of 15 mg/kg body weight to rapidly build up therapeutic serum concentrations. The dose required to maintain a stable concentration of the drug is 1.9 mg / kg / 24 hours. For patients with severe renal insufficiency, it is advisable to administer maintenance doses of 250-1000 mg once every few days (with CC 10-50 ml / min - 1 g every 3-7 days, less than 10 ml / min - 1 g every 7-14 days). For anuria, the recommended dose is 1 g every 7-10 days.

With pseudomembranous colitis caused by Clostridium difficile due to the use of antibiotics, as well as for the treatment of staphylococcal enterocolitis, the drug is prescribed orally (in / in the introduction of vancomycin has no advantages for the treatment of these diseases). Adults single dose is 0.5 - 2 g; for children, the dose is set at the rate of 0.04 g / kg of body weight. Multiplicity of reception 3-4 times / day. A single dose is diluted in 30 ml of water and taken orally or administered through a tube. To improve the taste of the solution, ordinary food syrups can be added to it. Duration of treatment - 7 - 10 days. Vancomycin by mouth is not effective for other infections.

Rules for preparing a solution for intravenous administration

The solution is prepared immediately before the administration of the drug. To do this, add the required volume of water for injection to a vial with a dry, sterile powder to obtain a solution with a concentration of 50 mg/ml. The resulting solution is subject to further dilution to a concentration of not more than 5 mg / ml. The required dose of vancomycin diluted in this way should be given by intravenous infusion over at least 60 minutes. As solvents, 5% dextrose solution for injection or 0.9% sodium chloride solution for injection can be used. Before injection, the prepared solution for parenteral administration should be checked visually, if possible, for the presence of mechanical impurities and discoloration.

With simultaneous intravenous administration of vancomycin and anesthetics, erythema and anaphylactoid reactions were detected. There is also a risk of a decrease in blood pressure or the development of neuromuscular blockade. Vancomycin is recommended to be administered before the administration of the anesthetic in the form of a 60-minute infusion, these preventive measures reduce the likelihood of these reactions.

With simultaneous and / or sequential systemic or local use of other potentially ototoxic and / or nephrotoxic drugs (aminoglycosides, amphotericin B, acetylsalicylic acid or other salicylates, bacitracin, capreomycin, carmustine, paromomycin, cyclosporine, loop diuretics, polymyxin B, cisplatin, ethacrynic acid ) requires careful monitoring of the possible development of these symptoms. Colestyramine reduces the activity of vancomycin. Antihistamines, meclozine, phenothiazines, thioxanthenes may mask the symptoms of the ototoxic effect of vancomycin (tinnitus, vertigo).

Pharmaceutical incompatibility

Vancomycin solution has a low pH, which can cause physical or chemical instability when mixed with other solutions. Avoid mixing with alkaline solutions. Solutions of vancomycin and beta-lactam antibiotics are physically incompatible when mixed. The likelihood of precipitation increases with increasing concentration of vancomycin. It is necessary to adequately flush the intravenous system between applications of these antibiotics. In addition, it is recommended to reduce the concentration of vancomycin to 5 mg / ml or less.

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