Treatment of patients with infections caused by staphylococcal species and streptococcal species; used orally for staphylococcal enterocolitis or for antibiotic-associated pseudomembranous colitis produced by C. difficile.
葡萄球菌感染所致之心內膜炎、骨髓炎、肺炎、敗血病、軟組織感染、腸炎、梭狀桿菌感染所致之假膜性結腸炎

Vancomycin is a tricyclic glycopeptides antibiotic. It inhibits bacterial cell wall synthesis by blocking glycopeptide polymerization through binding tightly to D-alanyl-D-alanine portion of cell wall precursor

Absorption: Oral: Poor; Intraperitoneal: ~38%; Distribution: Vd: 0.4-1 L/kg; Distributes widely in body tissue and fluids, except for CSF, CSF:blood level ratio: Normal meninges: Nil; Inflamed meninges: 20% to 30%; Excretion: I.V.: Urine (80% to 90% as unchanged drug); Oral: Primarily feces; Elimination Half-life: Adults: 5-11 hrs, significantly prolonged with renal impairment; CVVHD clears vancomycin from the circulation while conventional hemodialysis does not.

Hypersensitivity to vancomycin or any component of the formulation; avoid in patients with previous severe hearing loss.

B (oral)
C (injection)

Enters breast milk/not recommended

Ototoxicity, nephrotoxicity, rapid infusion may develop anaphylactoid reactions, including red man syndrome, hypotension, urticaria; reversible neutropenia.

Adults: 2-3 g/day (or 30-60 mg/kg/day) in divided doses every 8-12 hours; Note: Dose requires adjustment in renal impairment. Each gram should be administered over a period of at least 60 minutes.
Older infants and children: IV 40mg/kg/day in 2-4 divided doses.
In neonates: an initial dose of 15mg/kg is suggested followed by 10mg/kg every 12 hours in the first week of life and every 8 hours thereafter up to the age of one month.
antibiotic-associated pseudomembranous colitis: the usual adult daily dosage is 500 mg to 2g orally in 3 or 4 divided doses for 7 to 10 days, the total daily dosage should not be exceeded 2g.

Dose requires adjustment in renal impairment.
ESRD患者之使用劑量：第一天loading dose: 15 mg/kg, 第四天：15 mg/kg，之後每7天給15 mg/kg