萬古黴素

用途

• Confirmed bacteremia/septicemia for enterococci or staphylococci resistant to other commonly used antibiotics
• Serious infections
• Confirmed bacteremia/septicemia for enterococci or staphylococci resistant to other commonly used antibiotics
• Serious infections
• C. difficile enterocolitis
• Skin, urinary, soft tissue infections
• Systemic infections, bacteremia

給藥方式

可能的副作用

• Nephrotoxicity (especially with concurrent nephrotoxic drugs)
• Ototoxicity (hearing loss/vestibular signs)
• Thrombophlebitis (if given IV too rapidly)
• Severe hypotension or cardiac arrest (rare, associated with rapid IV bolus)
• Severe tissue damage and pain (if given IM, SC, or IP)
• Nausea and inappetence (with oral administration)
• Reversible neutropenia (with high/prolonged dosing)
• Hypersensitivity/dermatologic reactions (known in humans as 'Red Man Syndrome' due to histamine release)

注意事項與禁忌

• Infections susceptible to other, lower-tier antibiotics
• Intramuscular (IM), Subcutaneous (SC), or Intraperitoneal (IP) administration
• Rapid IV bolus administration
• Must be administered IV over at least 30-60 minutes as a dilute solution to prevent thrombophlebitis and severe hypotension. Dosages must be reduced or dosing intervals increased in patients with renal dysfunction. Therapeutic drug monitoring (trough levels) is highly recommended. Strictly reserve for multi-drug resistant infections to prevent the emergence of Vancomycin-Resistant Enterococci (VRE) or Staphylococci (VRSA).

藥物相互作用

• Aminoglycosides (e.g., gentamicin, amikacin): Synergistic antibacterial effect, but significantly increases the risk of ototoxicity and nephrotoxicity. Enhanced monitoring is required.
• Anesthetic agents: May cause erythema and histamine-like flushing (reported in human pediatric patients).
• Nephrotoxic drugs (e.g., amphotericin B, cisplatin): Increased risk of severe nephrotoxicity; use together with extreme caution.

常見問題