Vancomycin
Aliases: Vancocin
Last verified: 2026-09-23
The short version
A glycopeptide antibiotic — for decades the "last line" against MRSA; orally for C. difficile.
Identity & type
- Molecular type
- peptide
- Origin
- A glycopeptide antibiotic — for decades the "last line" against MRSA; orally for C. difficile.
Mechanism of action
Binds D-Ala-D-Ala termini of peptidoglycan → blocks cell-wall synthesis.
Dosing & routes
Official / clinical context
Approved drug — indications, dosing and warnings are defined by the official label. IV 15–20 mg/kg 2–3×/day (AUC-guided); oral 125 mg 4×/day (C. diff).
Regulator-approved labeling and published study designs — never a recommendation.
Community-reported practice
IV 15–20 mg/kg 2–3×/day (AUC-guided); oral 125 mg 4×/day (C. diff). A decades-long MRSA standard: effective, but requires kidney and drug-level monitoring.
Unverified self-reports. Not medical advice. Not endorsement.
Expected effects (community)
A decades-long MRSA standard: effective, but requires kidney and drug-level monitoring.
Protocol — official vs community
Official / label
Serious gram-positive infection (MRSA foremost): IV 15–20 mg/kg every 8–12 h, dosed by actual body weight and guided by AUC/MIC (target AUC₂₄ 400–600 mg·h/L). Oral vancomycin 125 mg four times daily is a separate, non-absorbed indication for C. difficile colitis.
Duration: Days to ~6 weeks depending on infection; oral C. difficile courses run 10 days per guideline.
Modern dosing is AUC-guided rather than trough-guided; inadequate exposure breeds resistance and failure, excessive exposure buys nephrotoxicity. 'Red man' syndrome is an infusion-rate reaction, not an allergy.
Community (anecdotal)
Structured protocol data for this entry is coming.
Human evidence
A classic since 1958; resistance (VRE/VISA) monitored.
Preclinical evidence
The preclinical phase was completed and submitted to regulators as part of registration; pharmacology and toxicology details are part of the official label.
Known risks
- Nephrotoxicity, "red man" syndrome, ototoxicity.characterized
Teal: characterized in clinical/labeling contexts. Amber: theoretical or reported outside controlled settings.
Unknowns & evidence gaps
- Real-world data outside controlled trials