Vancomycin
David L. Goldman MD1
1 Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
Editors: Henry M. Adam, MD.
Vancomycin, a glycopeptide antibiotic first isolated from the organism Amycolatopsis orientalis in 1956, was used initially to treat penicillin-resistant staphylococcal infections prior to the development of methicillin. It is selectively bactericidal against most gram-positive organisms, with almost no activity against gram-negative organisms. Several mechanisms of antimicrobial activity have been described for vancomycin, the primary one being interference with cell wall synthesis. Other mechanisms of action include alteration of bacterial cell membrane permeability and interference with messenger RNA synthesis. Because vancomycin and betalactam antibiotics act at different sites and stages of cell wall synthesis, no cross-resistance occurs.
Vancomycin is not absorbed well following oral administration and should be administered intravenously except for the treatment of Clostridium difficile colitis.
