Vancomycin hydrochloride have the clinical effects

Clinical effect of vancomycin hydrochloride  

1. This drug is used for serious gram-positive bacterial infection, especially serious infection caused by methicillin-resistant Staphylococcus aureus, Staphylococcus epidermis and enterococcus caused by other antimicrobial drugs resistant or poor efficacy (such as endocarditis, meningitis, osteomyelitis, pneumonia, septicemia or soft tissue infection, etc.);  Also used in patients allergic to β -lactam antibiotics for the above severe infection.  

2. This drug can be used to treat the arteriovenous shunt infection caused by staphylococcus in hemodialysis patients.  

3. Oral application for the treatment of pseudomembranous colitis by metronidazole treatment ineffective, or multiple drug resistance staphylococcal enterocolitis.  

Pharmacodynamics of vancomycin hydrochloride  

Mechanism of action Vancomycin is a kind of glycopeptide antibiotic, and vancomycin hydrochloride is its hydrochloride.  The mechanism of its action is that alanyl alanine binds to the terminal of the precursor peptide of sensitive bacterial cell wall with high affinity, and blocks the synthesis of the polymer peptidoglycan that constitutes bacterial cell wall, leading to cell wall defect and killing bacteria.  In addition, it may alter bacterial cell membrane permeability and selectively inhibit RNA synthesis.  The drug has strong bactericidal effect on gram-positive bacteria.  Oral administration of clostridium difficile pseudomembranous colitis has a good effect.  

Antibacterial spectrum has strong antibacterial activity to Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes, Streptococcus pneumoniae, etc.  It also has certain antibacterial effect on anaerobic streptococcus, Clostridium difficile bacillus, anthrax bacillus, actinomycetes, diphtheria bacillus, Neisseria gonorrhoeae, streptococcus viridis, streptococcus bovis and streptococcus faecalis.  It is not effective against most gram-negative bacteria, mycobacteria, rickettsia, chlamydia or fungi.  

Pharmacokinetics of vancomycin hydrochloride  

Gastrointestinal malabsorption, intravenous administration can be widely distributed in most tissues and body fluids throughout the body.  The peak plasma concentrations were 10-30mg /L and 25-50mg /L, respectively, after 0.5g and 1.0g intravenous infusion.  The distribution volume of this drug is 0.43 ~ 1.25L/kg.  Effective antibacterial concentration can be achieved in serum, pleura, pericardium, peritoneum, ascites and synovial fluid, and higher in urine, but not in bile.  Drugs can pass through the placenta or into the milk, but not quickly into the CEREBROspinal fluid through the normal blood-cerebrospinal fluid barrier. When the meninges become inflamed, they can penetrate into the cerebrospinal fluid and reach effective antibacterial concentration.  The protein binding rate of this drug is about 55%.  The average elimination half-life of adults is 6 hours (4-11 hours), and the half-life of patients with severe renal insufficiency can be extended to 7.5 days.  The half-life of elimination in children is about 2-3 hours.  Drugs can be metabolized by the liver.  About 80% ~ 90% of the dose is excreted by glomerular filtration through urine in primitive form within 24 hours, and a small amount is excreted through bile.  Hemodialysis or peritoneal dialysis can not effectively remove this drug;  However, it has been reported that blood perfusion or blood filtration can improve clearance.