GLYCOPEPTIDES

(Vancomycin)

PHCL-L3-AntiMicro-lecture

10/13/23 1
 Learning Objectives
• Discuss the mechanism of action of
vancomycin
• Describe the pharmacokinetic properties of
vancomycin
• Describe the spectrum of activity of
vancomycin
• Describe the clinical uses of vancomycin
• Describe the adverse effects due to
vancomycin
10/13/23 2
 GLYCOPEPTIDES
Examples: Vancomycin & Teicoplanin & Telavancin

Vancomycin
Mechanism of action
Inhibits cell wall synthesis
Antibacterial activity
Bactericidal against aerobic G+ bacteria, especially Staphyllococc
( including B- lactamase producing & MRSA ) & anaerobic G+
(c.difficile)
Not effective against G - bacteria
10/13/23 4
 Vancomycin
Pharmacokinetics
• Not absorbed from GIT( given oraly in antibiotic- associated
colitis, esp. if caused by c. difficile )
• It is given i.v
• Widely distributed ( including CSF in inflammation )
• Only 10 % bound to plasma protein
• Eliminated entirely by glomerular filtration
• Accumulate in renal impairement
• Half- life approx. 8 hr
 Vancomycin
Side effects
• Fever , rashes
• Thrombophlebitis at the site
of injection
• Ototoxicity & nephrotoxicity
( High conc. )
• Hypotension
• red man ( red neck )
syndrome
10/13/23 7
10/13/23 8
 Vancomycin - Summary
• Drug of choice - MRSA
• Good against most Gram positive organisms
• Little or no activity against Gram negative
organisms
• Good for enterococcus but not VRE
• Held in reserve for S. pneumoniae with high
level resistance to cephalosporins

10/13/23 9
10/13/23 10