2. GLYCOPEPTIDES Vancomycin ; Teicoplanin Vancomycin Mechanism of action Inhibits cell wall synthesis Antibacterial activity Bactericidal against aerobic G+ bacteria, especially Staphyllococci ( including B- lactamase producing & MRSA ) & anaerobic G+ (c.difficile) Not effective against G - bacteria

3. Vancomycin ( cont. ) Pharmacokinetics Not absorbed from GIT( given oraly in antibiotic- associated colitis, esp. if caused by c. difficile ) It is given i.v Widely distributed ( including CSF in inflammation ) Only 10 % bound to plasma protein Eliminated entirely by glomerular filtration Accumulate in renal impairement Half- life approx. 8 hr

4. Vancomycin ( cont. ) Clinical uses Serious staph.infections caused by MRSA or MRSE Prophylaxis for major surgical procedures in hospitals with high rates of infections due to MRSA or MRSE Antibiotics-associated colitis – metronidazole is preffered ) Vancomycin- resistant staph use Daptomycin

5. Vancomycin ( cont. ) Side effects Fever, rashes Thrombophlebitis at the site of injection Ototoxicity & nephrotoxicity ( High conc. ) Hypotension & red man ( red neck ) syndrome( rapid infusion )