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Antibacterial; tricyclic glycopeptide antibiotic. Uses for Vancomycin Hydrochloride Endocarditis Treatment of native valve or prosthetic valve endocarditis caused by susceptible Staphylococcus aureus or S. Epidermidis, including oxacillin-resistant (methicillin-resistant) strains. AHA and IDSA recommend vancomycin as drug of choice for treatment of endocarditis caused by oxacillin-resistant staphylococci.

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Also recommended as alternative to nafcillin (or oxacillin) or cefazolin for treatment of endocarditis caused by oxacillin-susceptible staphylococci in patients with immediate-type (anaphylactoid) hypersensitivity to β-lactams. May be used alone for native valve endocarditis caused by oxacillin-susceptible staphylococci; used in conjunction with rifampin and gentamicin for endocarditis caused by oxacillin-resistant staphylococci and for prosthetic valve staphylococcal endocarditis. Treatment of native valve or prosthetic valve endocarditis caused by viridans streptococci or Streptococcus bovis. Recommended by AHA and IDSA as an alternative to penicillin G or ceftriaxone for treatment of streptococcal endocarditis in patients with immediate-type (anaphylactoid) hypersensitivity to β-lactams. Treatment of native valve or prosthetic valve enterococcal endocarditis; used in conjunction with gentamicin or streptomycin.

Recommended by AHA and IDSA as an alternative to penicillin G or ampicillin for treatment of enterococcal endocarditis in patients with immediate-type (anaphylactoid) hypersensitivity to β-lactams. Empiric treatment of culture-negative endocarditis.

For culture-negative native valve endocarditis, regimen of ampicillin-sulbactam and gentamicin recommended by AHA and IDSA; regimen of vancomycin, gentamicin, and ciprofloxacin recommended for those unable to tolerate penicillin. For culture-negative prosthetic valve endocarditis occurring ≤1 year after valve replacement, regimen of vancomycin, gentamicin, and rifampin recommended; this regimen also should include cefepime if onset of infection is within 2 months of valve replacement. Selection of the most appropriate anti-infective regimen is difficult and should be guided by epidemiologic features and clinical course of the infection. Consultation with an infectious diseases specialist is recommended. Treatment of early-onset prosthetic valve endocarditis caused by Corynebacterium jeikeium (JK group); used in conjunction with rifampin and/or an aminoglycoside.

Prevention of bacterial endocarditis in patients undergoing certain genitourinary and GI (except esophageal) procedures who have cardiac conditions that put them at moderate or high risk. AHA recommends ampicillin as a drug of choice; vancomycin recommended in those hypersensitive to penicillins. Used alone in penicillin-allergic individuals at moderate risk or in conjunction with gentamicin in those at high risk. Consult most recent AHA recommendations for specific information on which cardiac conditions are associated with high or moderate risk of endocarditis and which procedures require prophylaxis. Meningitis Treatment of meningitis caused by S. Pneumoniae that are highly resistant to penicillins.

For empiric treatment, usually used in conjunction with a third generation cephalosporin (ceftriaxone, cefotaxime) with or without rifampin; vancomycin should be discontinued if the causative organism is found to be susceptible to the cephalosporin. Should not be used alone for treatment of meningitis since effective CSF concentrations may not be attained. Osteomyelitis Treatment of osteomyelitis caused by S. Epidermidis, including oxacillin-resistant strains. Respiratory Tract Infections Treatment of pneumonia caused by S. Epidermidis, including oxacillin-resistant strains.

Treatment of pneumonia caused by S. Pneumonia highly resistant to penicillins. Used alone or in conjunction with a third generation cephalosporin (ceftriaxone, cefotaxime) with or without rifampin.