Vancomycin and teicoplanin are glycopeptide antibiotics used to treat serious gram-positive infections like MRSA. Vancomycin is administered intravenously or orally to treat infections and dosed based on creatinine clearance, age, and weight. Teicoplanin can be given intravenously, intramuscularly, or orally once daily after a loading dose with dosing based on creatinine clearance, age, and weight. Both antibiotics require monitoring for nephrotoxicity and ototoxicity as side effects and have drug interactions with aminoglycosides and diuretics. They are supplied as powders for reconstitution and stored below 25°C.

1. VANCOMYCIN
Mohammed – Alrjoub

2.  General info
 Clinical info
1- indications
2- dosage and administration
3- CI
4- DI
5- precautions
 Pharmaceutical info: dosage forms and storage
conditions

3. GENERAL INFORMATION
 MOA: Cell wall synthesis inhibitor
 Antibacterial spectrum: G+ organisms ( most
important MRSA and drug resistant enterococci)

4. CLINICAL INFO:
INDICATION
 For serious G+ infections or those who have an
allergy to penicillin
 MRSA and MRSE
 Orally for life threatening Clostridium Difficile
associated colitis
 With aminoglycosides for enterococcal endocarditis

5. CLINICAL INFO:
DOSAGE AND ADMINISTRATION
 By slow iv infusion over 60-90 min depending on
dose
a. 500mg q.6.h over 1h or 1g bid over 100min
b. at a rate no more than 10mg/min
 Preferred to be intermittent iv inf.
 Dose depends on CLcr , age, and B.wt.

6. CLINICAL INFO:
DOSAGE AND ADMINISTRATION
 Preparation:
1- Add 10 ml of sterile WFI to a 500 mg vial of
Vancomycin powder >> 50 mg/ml
2- Reconstituted solutions containing 500 mg vancomycin
must be diluted with at least
100 ml diluent. (NaCl soln. or Dextrose soln.)

7. CLINICAL INFO:
C/I
 History of deafness
 Renal impairment (adjust dose)

8. CLINICAL INFO:
S/E
 Red man syndrome: flushing and shock if infused
rapidly
 Ototoxicity
 Nephrotoxicity
 Fever ,chills and phlebitis

9. CLINICAL INFO:
DI
 Aminoglycosides, furosemide
 Anesthetics: hypersensitivity

10. PRECAUTIONS
 Renal impairment
 Rapid infusion
 Monitor renal function and hearing
 Pregnancy: BM
 Breast feeding: oral absorption is poor but problems
with bowels normal flora and allergic effects have
been reported

11. PHARMACEUTICAL INFO:
DOSAGE FORM AND STORAGE CONDITIONS
 Vancocin
 Vancoled
500 mg vial
 Store in airtight container and protect from light

12. TEICOPLANIN

13. GENERAL INFORMATION
 Glycopeptide antibiotic
 MOA: Cell wall synthesis inhibitor
 Antibacterial spectrum: G+ organisms ( most
important MRSA and drug resistant enterococci)

14. CLINICAL INFO:
INDICATION
 For serious G+ infections or those who have an allergy
to penicillin
 MRSA and MRSE
 Orally for life threatening Clostridium Difficile associated
colitis
 For endocarditis
 Treating infection of the abdominal cavity (peritonitis)
associated with peritoneal dialysis.

15. CLINICAL INFO:
DOSAGE AND ADMINISTRATION
 ROA: Intraperitoneally, IM, IV (inf and bolus), po
 Given once daily after the loading dose
 Dose depends on age, CLcr, and wt

16. CLINICAL INFO:
DOSAGE AND ADMINISTRATION
 Preperation:
1- add water from the ampoule into the vial (3ml)
2- rotate gently between hands to dissolve the
powder be careful not to form foam…. If foam
develops leave the soln to stand for 15min
3- dilute with NaCl soln, Lactate Ringers, or
Dextrose soln or NaCl with dextrose soln.
4- add lidocaine 0.5 or 1% if IM
** the final soln. is stable for about 24hrs at 2-8◦ c
(beware of contamination)

17. CLINICAL INFO:
C/I
 Hypersensitivity
 Renal impairment (adjust dose)

18. CLINICAL INFO:
S/E
 Common: pain, fever, rash, itching, redness of skin,
NVD
 Hearing loss and balance disorders
 Liver and kidney function changes
 Rare: change in blood cell count

19. CLINICAL INFO:
DI
 Aminoglycosides
 furosemide
 Amphotericin B
 Cyclosporine

20. PRECAUTIONS
 Renal impairment
 Allergy to vancomycin (cross-allergy)
 Monitor renal function, liver function,hearingand
blood
 Superinfection
 Pregnancy, breast feeding: unknown
 Contains 24.8mg Na

21. PHARMACEUTICAL INFO:
DOSAGE FORM AND STORAGE CONDITIONS
 Targocid (Sanofi Aventis)
200,400 mg vial
 Store under 25◦ c