Why Is Vancomycin Used as a Last Resort?

By Alice Nichols

Vancomycin is a powerful antibiotic used to treat serious bacterial infections. It is considered a “last resort” medication, which means it is typically only used when other antibiotics have failed to work or when the infection is caused by bacteria that are resistant to other antibiotics.

What Is Vancomycin?

Vancomycin is a glycopeptide antibiotic that was first discovered in the 1950s. It works by preventing bacteria from forming cell walls, which ultimately leads to their death. Vancomycin is effective against a wide range of gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile.

Why Is Vancomycin Used as a Last Resort?

Vancomycin is typically reserved for use as a last resort because it can have serious side effects and can contribute to the development of antibiotic-resistant bacteria. Additionally, vancomycin is administered intravenously (through an IV), which can make it more difficult to administer than oral antibiotics.

Side Effects of Vancomycin

Some of the common side effects of vancomycin include:

  • Nausea and vomiting
  • Headache
  • Rash
  • Fever
  • Hearing loss or ringing in the ears (tinnitus)

In rare cases, vancomycin can also cause more serious side effects such as kidney damage and severe allergic reactions.

Antibiotic Resistance and Vancomycin

The overuse or misuse of antibiotics can lead to the development of antibiotic-resistant bacteria, which are able to survive even in the presence of antibiotics. This has become a major public health concern in recent years.

Vancomycin-resistant Enterococcus (VRE) and vancomycin-resistant Staphylococcus aureus (VRSA) are two examples of bacteria that have developed resistance to vancomycin. These types of infections can be extremely difficult to treat, and in some cases, may even be fatal.

When Is Vancomycin Used?

Vancomycin is typically used to treat serious bacterial infections, such as:

  • Bacterial endocarditis (an infection of the heart valves)
  • Meningitis (an infection of the lining of the brain and spinal cord)
  • Pneumonia
  • Septicemia (a bloodstream infection)

It is also sometimes used to treat infections caused by MRSA or C. difficile.

Conclusion

Vancomycin is a powerful antibiotic that is reserved for use as a last resort due to its potential side effects and contribution to antibiotic resistance. While it can be effective in treating certain serious bacterial infections, it should only be used when other antibiotics have failed or when the infection is caused by bacteria that are resistant to other antibiotics.