Casetta A, Bingen E, Lambert-Zechovsky N
Laboratoire de Bactériologie, Hôpital Robert Debré, Paris, France.
Pathol Biol (Paris). 1991 Sep;39(7):700-8.
Vancomycin is a narrow-spectrum glycopeptide antibiotic which is primarily active against Gram-positive organisms. Bacterial resistance develops rarely due to its numerous modes of action. The mode of action of vancomycin involves the inhibition of peptidoglycan synthesis. Vancomycin forms a stoichiometric complex with the peptidoglycan precursor UDP-N-acetylmuramyl pentapeptide by forming hydrogen bonds. In patients with renal insufficiency vancomycin clearance is reduced and elimination half-life prolonged. Vancomycin is the drug of choice in the treatment of methicillin-resistant staphylococcal infections and in the treatment of Gram-positive endocarditis and has been used as alternative therapy in the treatment or prophylaxis of Gram-positive infections in penicillin-allergic patients.
万古霉素是一种窄谱糖肽类抗生素，主要对革兰氏阳性菌有活性。由于其多种作用方式，细菌耐药性很少出现。万古霉素的作用方式包括抑制肽聚糖合成。万古霉素通过形成氢键与肽聚糖前体UDP-N-乙酰胞壁酰五肽形成化学计量复合物。在肾功能不全患者中，万古霉素清除率降低，消除半衰期延长。万古霉素是治疗耐甲氧西林葡萄球菌感染以及革兰氏阳性菌心内膜炎的首选药物，并且已被用作青霉素过敏患者革兰氏阳性菌感染治疗或预防的替代疗法。
