• Severe bacterial infections in adults:
    • IV 15-20mg/kg/dose BD/TDS
      • Consider starting at 20-35mg/kg/dose *1 in seriously ill patients. Max 3g/dose
  • Severe bacterial infections in children:
    • < 7 days (<1.2kg):
      • IV 15mg/kg/dose OD
    • <7 days (1.2-2 kg):
      • IV 10-15mg/kg/dose every 12-18 hours
    • <7 days old (>2.1 kg):
      • IV 10-15mg/kg/dose BD/TDS
    • ≥7 days (<1.2kg):
      • IV 15mg/kg/dose OD
    • ≥7 days (1.2-2 kg):
      • IV 10-15mg/kg/dose BD/TDS
    • ≥7 days(>2.1 kg):
      • IV 15-20mg/kg/dose TDS
    • 1-3 months:
      • IV 10-15mg/kg/dose TDS/QID. Max: 1 g/dose
    • 4 months-11 years:
      • IV 60-80mg/kg/day divided TDS/QID. Max: 100mg/kg/day
    • ≥12 years: IV 1000mg BD OR 10-15mg/kg/dose BD
  • C.difficile infection:
    • Non-fulminant:
      • PO 125mg QID *10/7
    • Fulminant:
      • Adults: PO/NG 500mg QID
      • Children: PO/PR 40mg/kg/day divided QID *10/7. Max: 500mg/dose
    • 1st recurrence:
      • PO 125mg QID *10-14 days, then 125mg BD *1/52, then 125mg OD *1/52, then 125mg every 2-3 days for 2-8 weeks
      • May give PO 125mg QID *10/7 if metronidazole initial regimen
    • 2nd recurrence:
      • Adults: PO 125mg QID *10-14 days, then 125mg BD *1/52, then 125mg OD *1/52, then 125mg every 2-3 days *2-8 weeks OR PO 125mg QID *10/7, then rifaximin *20/7
      • Children: PO 10mg/kg/dose QID *14/7, then 10mg/kg/dose BD *7-14 days, then 10mg/kg/dose OD *7-14 days, then 10mg/kg/dose OD for 2-3 days *2-8 weeks. Max: 125 mg/dose OR 10mg/kg/dose QID *1/52, then 10mg/kg/dose TDS *1/52, then 10mg/kg/dose BD *1/52, then 10mg/kg/dose OD *1/52, then 10mg/kg/dose every 2 days *1/7, then 10mg/kg/dose every 3 days *1/52
        • 10mg/kg/dose QID *14/7, then rifaximin *14/7 or nitazoxanide *10/7
    • Non-severe in children:
      • PO 40mg/kg/day divided QID *10/7
      • Max: 125mg/dose
  • Staphylococcal enterocolitis:
    • Adults:
      • PO 500-2000mg/day divided TDS/QID *7-10 days
    • Children:
      • PO 40mg/kg/day divided TDS/QID *7-10 days
      • Max: 500mg/dose, 2000mg/day
  • Community or hospital-acquired pneumonia:
    • Adults:
      • IV 15-20mg/kg/dose divided BD/TDS *1/52
      • Consider starting IV 20-35mg/kg/dose IV *1 in seriously ill patients. Max 3g/dose
    • Children >3months:
      • IV 40-60mg/kg/day divided TDS/QID *10-14 days
  • Endocarditis:
    • Adults:
      • IV 15-20mg/kg/dose divided BD/TDS for at least 4 weeks
      • Consider starting 20-35mg/kg/dose *1 in seriously ill patients, max 3g/dose
    • Children:
      • IV 40-60mg/kg/day divided BD/QID *4-6 weeks
  • Systemic anthrax (Off-label):
    • Adults:
      • IV 60mg/kg/day divided TDS for at least 2 weeks
      • May be part of multi-drug regimen including gentamicin gram positive synergy
      • Consider starting 20-35mg/kg/dose *1 in seriously ill patients, max 3g/dose
    • Children:
      • Neonates >32 weeks gestation: IV 10-20mg/kg/dose every 12-48 hours for at least 2 weeks
      • ≥1 month: IV 60mg/kg/day divided TDS for at least 2 weeks
  • Bacterial endophthalmitis (Off-label):
    • Adults and children ≥2 months: 1mg in 0.1ml sterile water or saline intravitreally *1
      • May repeat every 48 hours *1
      • Part of multi-drug regimen
  • Bacterial meningitis (Off-label):
    • IV 15-20mg/kg/dose BD/TDS
    • Part of multi-drug regimen
    • Consider starting 20-35mg/kg/dose *1 in seriously ill patients, max 3g/dose

Injection: 500mg

  • IV form may be given orally
  • To be taken with food if used orally
  • IV administration given preferably intermittently over 60 minutes. Max 10mg/min
  • IV administration can also be administered continuously over 24 hours

Glycopeptide

It inhibits cell-wall biosynthesis by blocking glycopeptide polymerization by binding tightly to D-alanyl-D-alanine portion of cell wall precursor

  • Vancomycin flushing syndrome (rapid IV use)
  • Hypotension (rapid IV use)
  • Fever
  • Nausea
  • Rigors
  • Eosinophilia
  • Rash
  • Urticaria
  • Phlebitis
  • Tinnitus
  • Dizziness
  • Vertigo
  • Elevated BUN or Cr
  • Vomiting (PO use)
  • Flatulence (PO use)
  • Hypersensitivity to class/components
  • Intraocular prophylaxis use during cataract surgery

WARNING

Single-dose flexible bags are not recommended for use during pregnancy because it contains the excipients polyethylene glycol (PEG) 400 and N-acetyl-D-alanine (NADA), which caused fetal malformations in animal reproduction studies

  • Cidofovir

                          Drug Status

Availability Prescription only
Pregnancy Weigh risk vs benefit
Breastfeeding Can be used
Schedule Not controlled
BRAND NAME STRENGTH FORMULATION PACK SIZE MANUFACTURER DISTRIBUTOR
Vamocin 500mg Injection 1’s Gufic Stridden Europa Healthcare
Vancocin 500mg Injection 1’s Eli Lilly Statim Pharma
Vancolon 500mg Injection 1’s Julphar Pharma Pharmamed Solution
Vencozed 500mg Injection 1’s Zawadi Healthcare Zawadi Healthcare