How to Use Vancomycin Hydrochloride?

Vancomycin hydrochloride is a narrow-spectrum antibiotic mainly used to treat diseases caused by Gram-positive bacterial infections, commonly including hemolytic streptococci, Streptococcus pneumoniae, and Enterococcus. Vancomycin hydrochloride is suitable for the treatment of many types of diseases, and the usage may vary depending on the specific condition. Some patients may be unfamiliar with its usage when they first encounter this medication. So, how should vancomycin hydrochloride be used? Let's take a look below.

Vancomycin hydrochloride is administered intravenously only. For adults, the dosage is 1g to 2g per day, divided into 2 to 4 doses. For children, the dosage is 20mg to 40mg per kg per day, and for newborns, it is 12.5mg to 25mg per kg per day, also divided into 2 to 4 doses. Vancomycin hydrochloride is a narrow-spectrum antibiotic effective only against Gram-positive bacteria, such as hemolytic streptococci, Streptococcus pneumoniae, and Enterococcus. Its mechanism of action is to inhibit the synthesis of bacterial cell walls by binding to them, preventing certain amino acids from entering the glycopeptide of the cell wall. Clinically, it is mainly used for severe infections caused by penicillin-resistant Staphylococcus aureus, such as pneumonia, endocarditis, and sepsis, and it also has good efficacy in the treatment of infections and sepsis caused by hemolytic streptococci.

1. Contraindications: Patients who are allergic to this drug or vancomycin antibiotics.

2. Cautions: (1) Patients with severe renal insufficiency. (2) Patients with hearing loss or a history of deafness. (3) Pregnant and lactating women. (4) Elderly patients.

3. Effect on the elderly: This drug poses a high risk of ototoxicity and nephrotoxicity in elderly patients (hearing loss). As renal function decreases with age, it is necessary to adjust the dosage or dosing interval when indicated.

4. Effect on pregnancy: This drug can pass through the placenta and cause damage to the eighth cranial nerve of the fetus. Therefore, pregnant women should carefully consider the risks and benefits when indicated.

5. Effect on lactation: This drug can be secreted into breast milk, and lactating women should carefully consider the risks and benefits when using it.

6. Effect on test values or diagnosis: A few patients may experience an increase in blood urea nitrogen (BUN) after using this drug.

7. Tests or monitoring before, during, and after medication: (1) Regular hearing checks should be performed during long-term use. (2) Regular monitoring of renal function, urine protein, casts, cell count, and urine specific gravity should be performed during long-term use. (3) Blood drug concentration should be monitored, especially in patients who require extended treatment or have renal insufficiency, hearing loss, or a history of deafness. The peak blood concentration should not exceed 25-40mg/L, and the trough concentration should not exceed 5-10mg/L. Blood peak concentrations above 50mg/L and trough concentrations above 10mg/L indicate toxicity.