Vancomycin (Enteral)

C. diff Risk

None

Oral Bioavailability

None

Approximate Cost

$6/day

Spectrum Of Activity

Dosing

There are no dosage adjustments provided in manufacturer's labeling; however, dosage adjustment unlikely due to low systemic absorption.

There are no dosage adjustments provided in the manufacturer's labeling; however, dosage adjustment unlikely due to low systemic absorption.

Note that therapeutic interchange for adults suggests dosing of 125 mg PO QID.

For severe or recurrent infection (Oral, rectal enema): 40 mg/kg/DAY divided QID for ≥10 days; Max dose 2000 mg/day; if complete ileus, rectal enema dosage form may be preferable.

C. difficile-associated diarrhea (Infants, Children, and Adolescents): PO 40 mg/kg/DAY divided TID or QID for 7 to 10 days. Max 2000 mg/DAY.

General Information

Common Usage

Only indication is in the therapy of C. difficile infection, particularly recurrent or severe disease

Drug Monitoring

Possibility of accumulation in severe renal dysfunction; consider checking a vancomycin level in dialysis patients

Adverse Effects

Nausea, vomiting, diarrhea

Major Interactions

Avoid concurrent administration of oral vancomycin and bile acid sequestrants (may dimish therapeutic effect of vancomycin).

Additional Information

No oral absorption.

May increase vancomycin resistant enterococci colonization in the gut

Cost listed above reflects oral liquid. Capsules are almost 10X more costly

Pharmacology

Antimicrobial class: glycopeptide

Average serum half life: serum half life not available due to low systemic absorption

Route of Elimination: Primarily feces as limited absorption