Vancomycin

What it is

Vancomycin (Vancocin) is a glycopeptide antibiotic in widespread clinical use for over 60 years. Vancomycin products are FDA-approved for serious gram-positive infections including MRSA bacteremia, endocarditis, and several other indications. Oral vancomycin is approved for C. difficile colitis and S. aureus enterocolitis.

Mechanism of action

Inhibits bacterial cell wall synthesis through binding to peptidoglycan precursors. Active against most gram-positive organisms including MRSA, though vancomycin-intermediate and vancomycin-resistant strains are increasingly encountered.

Approved indications

• Serious gram-positive infections (IV)
• C. difficile colitis (oral)
• S. aureus enterocolitis (oral)

Why this is out of scope at The Tide

Vancomycin is appropriately prescribed by infectious disease, hospital medicine, primary care, or surgery depending on context. IV use requires hospital or infusion-center administration. Oral use for C. difficile is typically managed by gastroenterology, infectious disease, or primary care. Not appropriate for an outpatient clinic.

Where to learn more

Infectious disease, hospital medicine, primary care, or gastroenterology depending on indication.