Abstract

A REVIEW ON THE USE OF VANCOMYCIN

Satish S.* and Arya P. P.

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Abstract

Vancomycin has concerns about nephrotoxicity since its approval in 1958. First preparations were named “Mississippi mud” and had notable impurities are the considerable reason for the nephrotoxicity. Through improved procedures, present preparations contain ∼90–95% vancomycin B (the active moiety). The rate of nephrotoxicity with use of modern preparations varies in the literature, with the occurance ranging from as low as 0% in the absence of concurrent nephrotoxins to over 40%. It is widely used in hospitals, indicated to fight serious infections caused by Gram-positive bacteria, mostly with the occurance of MRSA (methicillin-resistant Staphylococcus aureus), penicillin-resistant pneumococci among others. Additionally, it is used for the treatment of patients allergic to penicillins and cephalosporins. Dose recommendations, dilution rates and types of infusion are difficult and also result in toxic effects. The important adverse effects of vancomycin are: hypotension, phlebitis, nephrotoxicity, ototoxicity, hypersensitivity reactions, red man syndrome, neutropenia, chills, fever, interstitial nephritis. The use of vancomycin is still very common; however, inappropriate doses and long term therapy cause the risk of increasing minimum inhibitory concentrations (MICs), resulting in subtherapeutic levels, treatment failures and toxicity. Therefore, improve in administration of vancomycin, monitoring treatments from the beginning in order to make sure a safe and effective use of the drug.

Keywords: Vancomycin, Toxicity, Adverse effect.