Vancomycin freeze-dried powder for injection 1g №1

pharmachologic effect

Vancomycin has an antibacterial effect. The bactericidal effect of vancomycin is manifested as a result of inhibition of cell wall biosynthesis. In addition, vancomycin can alter the permeability of the cell membrane of bacteria and RNA synthesis. Cross-resistance between vancomycin and antibiotics of other classes is absent.

Indications

Infectious and inflammatory diseases of the severe course caused by pathogens susceptible to vancomycin (in case of intolerance or failure of other antibiotic therapies, including penicillins or cephalosporins): sepsis, endocarditis (as a monotherapy or as part of a combined antibiotic therapy), pneumonia, pulmonary abscesses, pulmonary heart disease, as a single therapy or as a part of a combined antibiotic therapy, pneumonia, endocarditis. and joints, infections of the skin and soft tissues. Pseudomembranous colitis caused by Clostridium difficile.

Contraindications

Neuritis of the auditory nerve, marked impaired renal function, I trimester of pregnancy, lactation (breastfeeding), hypersensitivity to vancomycin.

Use during pregnancy and lactation

The drug Vancomycin is contraindicated for use in the first trimester of pregnancy. Appointment of Vancomycin II and III trimesters is possible only for health reasons.

Composition

1 fl. contains vancomycin (in the form of hydrochloride) 1000 mg.

Dosage and administration

In / in drip, inside. Adults - 0.5 g of vancomycin every 6 hours or 1 g every 12 hours. To avoid collaptoid reactions, the duration of the infusion is at least 60 minutes, the rate is 10 mg / min. Children are usually prescribed vancomycin in a daily dose of 40 mg / kg, divided into single doses every 6 hours, each dose should be administered for at least 60 minutes. In patients with impaired renal excretory function, the dose of Vancomycin is reduced, taking into account the values ​​of creatinine clearance.

Inside, in the form of a solution: for adults - at a daily dose of 0.5–2 g, for children - 40 mg / kg (in 3–4 doses), the multiplicity of reception - 3-4 times a day.

Side effects

From the nervous system and sensory organs: vertigo, hearing loss, ringing in the ears.

From the side of the cardiovascular system and blood (blood formation, hemostasis): reversible neutropenia, leukopenia, eosinophilia, thrombocytopenia; rarely - agranulocytosis.

On the part of the digestive tract: nausea, vomiting, diarrhea, pseudomembranous colitis.

On the part of the urogenital system: nephrotoxicity (up to the development of renal failure), more often when combined with aminoglycosides or when administered for more than 3 weeks in high concentrations, manifested by an increase in plasma concentrations of creatinine and urea nitrogen; rarely, interstitial nephritis (in patients taking aminoglycosides at the same time, and in cases of impaired renal function).

Allergic reactions: rash (including exfoliative dermatitis), Stevens-Johnson syndrome, toxic epidermal necrolysis, vasculitis.

Others: post-infusion reactions (due to rapid administration) - anaphylactoid reactions (decrease in blood pressure, dizziness, rapid heartbeat, bronchospasm, fever), skin rash, red man syndrome (hyperemia of the upper half of the body), muscle spasm in the neck and back. Local reactions (in violation of the rules of infusion): thrombophlebitis, pain at the injection site, tissue necrosis at the injection site.

Drug interaction

When combined with aminoglycosides, amphotericin B, bacitracin, loop diuretics, Cisplatin, cyclosporine, polymyxin, the risk of hearing loss and kidney damage increases. Kolestiramin reduces the effectiveness of vancomycin when taken orally. The combined use of vancomycin with general anesthetics can lead to the development of erythema, histamine-like hot flashes and anaphylactic shock.

Overdosage

Symptoms: increased severity of side effects.

Treatment: symptomatic in combination with hemoperfusion and hemofiltration.

Storage conditions

The drug Vancomycin should be stored in a dry, protected from light, out of reach of children at a temperature not higher than 8 ° C.