GLYCOPEPTI

DES
MADDRIGAL, TRISTAN PAULO R.

VANCOMYCIN
Mechanism of Action:
Inhibits cell wall synthesis by binding to the
D-Ala-D-Ala terminus
Inhibits transglycosylase (prevents elongation and cross linking)
Cell becomes susceptible to lysis

VANCOMYCIN
Clinical Use:
Drug of Choice :
15-20 mg/kg IV q12
Infections caused by H-MRSA (including pneumonia, bacteremia, and
endocarditis)
Not recommended for S. aureus infection if susceptible to methicillin
Infections caused by Coagulase-Negative Staphylococcus (e.g.
prosthesis, CSF shunt infections, catheter-related infections)

Other uses:
Enterococci infections
Metronidazole-resistant C. difficile infections
Surgical prophylaxis for centers with high prevalence of MRSA

VANCOMYCIN
Adverse Reactions
Common:
Red man syndrome (infusion-related flushing)
Due to histamine release (non-allergic
reaction)
Give anti-histamine and then administer slowly
Phlebitis to injection site
IM route not recommended
GI disturbances (e.g. diarrhea, nausea, and
vomiting)

Occasional:
Ototoxicity (Reversible)
Nephrotoxicitiy (Reversible)
Especially when used with nephrotoxic agents
such as aminoglycosides

LINCOSAMID
ES
MADDRIGAL, TRISTAN PAULO R.

CLINDAMYCIN
Mechanism of Action:
Inhibits protein synthesis by binding to the
50S ribosomal subunit
Inhibits peptide bond formation

CLINDAMYCIN
Clinical Use:
Drug of Choice :
600 mg IV q6-8
Infections caused by C-MRSA (e.g. skin and soft tissue infections)
Not recommended for hospital-acquired MRSA
Not recommended for meningitis

Other uses:
Anaerobic infections ABOVE the level of the diaphragm (e.g. lung
abscess) except CNS
Not recommended for intra-abdominal infections (e.g. B. fragilis)
Alternative for staphylococcal infections to those with penicillin
allergy
Bacterial vaginosis (300 mg PO BID for 7 days)

CLINDAMYCIN
Adverse Reactions
Common:
GI disturbances (e.g. diarrhea, nausea, and vomiting)
Hypersensitivity

Occasional:
Pseudomembranous colitis
Most common cause of C. difficile mediated diarrhea
Treat with metronidazole or vancomycin