- Antibacterial activity
- Bactericidal if concentrations remain above MBC for sufficient length of time.
- Gram positive only
- Aerobic AND anaerobic activity
- Bacterial resistance
- Exists but not widespread.
- Resistance a human health concern. Use this drug ONLY if there are no other alternatives
- Drug has been held in reserve. Resistance is low.
- Concentrations and doses
- No absorption when given orally.
- Does not reach intracellular or reserved sites (IV)
- Toxicity Profile
- Life-threatening adverse effects occur. Incidence in veterinary patients is unknown.
- Relatively old antimicrobial
- Toxicity (high for an antimicrobial) limited its use
- Now reserved for resistant infections
- Role in veterinary medicine is questionable / questioned
Beneficial actions and effects
- Glycopeptide (antibiotic) that blocks cell wall cross-linking
- Gram positive aerobic and anaerobic bacteria susceptible
- Reserved for resistant Staphylococci and Clostridia
Resistance (by bacteria)
- Altered structure of (bacterial) target (last amino acid of cross-link peptide is substitued)
- Vancomycin resistant Staphylococci and Enterococci are reported with increasing frequency.
- Painful intramuscular injection.
- Immune-based reactions
- Hematologic effects (neutropenia, leukopenia, thrombocytopenia)
- NOT as nephrotoxic or ototoxic as once thought
- Widely distributed following intravenous administration though not to CSF (and not likely to other reserved spaces).
- Primarily eliminated via glomerular filtration (unchanged drug). Small amounts are excreted into bile. Metabolism very low.
- Poor absorption following oral administration (Is "local" GI therapy for C. difficile in people).
- Intravenous form for parenteral use
- Oral form for C. difficile
- Intravenous form lower cost for oral use
- Treatment of serious life-thratening infections by gram-positive bacteria unresponsive to other antibiotics. May be used for methicillin-resistant staphylococci.
- Use only when C&S results dictate.