Vancomycin is a tricyclic glycopeptide that has gained clinical importance thanks to its effectiveness against organisms such as MRSA and enterococci. It has activity against Gram-positive rods and cocci, Gram-negative rods are resistant to its bactericidal action.
Some clinical uses of IV vancomycin include treatment of infective endocarditis and sepsis caused by MRSA. Since vancomycin is poorly absorbed, it is used only in treatment of enterocolitis caused by C. difficile.
Vancomycin adverse effects include skin flushing (red-man syndrome), fever, chills and phlebitis at the infusion site. Ototoxicity and nephrotoxicity must be kept in mind when treating patients that are receiving other drugs.
Mechanism of action
As you can see in the animation below, vancomycin binds to the pentapeptides of the peptidoglycan monomers and prevents the transglycosylation step in peptidoglycan polymerization. This weakens the cell wall and damages the underlying cell membrane.
About the animation author
Dr. Gary Kaiser is a Professor of Microbiology at The Community College of Baltimore County, Catonsville Campus located in Baltimore, Maryland. Make sure you visit his excellent microbiology website: The Grapes of Staph.
Golan, David E (editor). “Principles of Pharmacology: The Pathophysiologic Basis of Drug Therapy”, 2nd edition. LWW: 2008.
Harvey, R; Champe, P (series editors). “Lippincott illustrated reviews: Pharmacology”, 4th edition. LWW: 2009.