Glycopeptide antibiotics are a unique class of medications without a common prefix or suffix. One of the most well-known drugs in this class is vancomycin. It’s important not to confuse vancomycin with aminoglycosides, which typically end in “-mycin.” Instead, notice the “-co” in vancomycin which links back to glyco in glycopeptide, helping you remember its classification.
What Does It Target?
Glycopeptides like vancomycin are primarily used against gram-positive bacteria, including MRSA and Clostridioides difficile (C. diff). They are commonly prescribed for:
- Bone infections
- Pneumonia
- Endocarditis
How It Works
Vancomycin inhibits bacterial cell wall synthesis, giving it a bactericidal effect. This makes it highly effective against resistant gram-positive infections.
Lecture on Glycopeptides (Vancomycin)
Key Nursing and Clinical Considerations
Vancomycin requires careful monitoring due to its toxicity and narrow therapeutic range. Here’s what to remember:
- Trough Levels: Draw levels before the fourth dose, aiming for 10–20 mcg/mL to ensure safe and effective dosing.
- Administration: Infuse slowly over more than 60 minutes to reduce the risk of infusion-related reactions (previously called Red-Man Syndrome) such as flushing, rash, and hypotension.
- Nephrotoxicity: Monitor BUN and creatinine as vancomycin can damage the kidneys.
- Ototoxicity: Watch for hearing changes, tinnitus, or vertigo.
- C. difficile Treatment: Use the oral form when treating C. diff, since the IV form does not effectively reach the gut.
You may be interested in: Glycopeptides (Vancomycin) NCLEX-Style Practice Questions
References:
Kizior, R. J., & Hodgson, K. (2023). Saunders nursing drug handbook (12th ed., p. 1215). Elsevier. ISBN 9780323930765
U.S. Food and Drug Administration. (2018). Vancomycin hydrochloride for injection [Prescribing information]. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/209481s000lbl.pdf