Cook F V, Farrar W E
Ann Intern Med. 1978 Jun;88(6):813-8. doi: 10.7326/0003-4819-88-6-813.
Vancomycin, virtually discarded after development of antistaphylococcal penicillins, has recently been receiving renewed attention. There are several clinical situations in which it appears to offer advantages over other available antimicrobial agents: infections due to methicillin-resistant staphylococci; bacterial endocarditis in patients allergic to penicillin; staphylococcal enterocolitis; staphylococcal infection in patients undergoing hemodialysis; infections caused by penicillin-resistant diphtheroids; and prophylaxis of bacterial endocarditis in patients with prosthetic valves or penicillin allergy. Its penetration into the cerebrospinal fluid suggests that vancomycin may be useful in treating certain infections of the central nervous system. Although its ototoxic and nephrotoxic potential cannot be ignored, these problems can be minimized by keeping the serum concentration at the proper level.
在抗葡萄球菌青霉素研发出来后几乎被弃用的万古霉素，最近又重新受到关注。在几种临床情况下，它似乎比其他现有的抗菌药物更具优势：耐甲氧西林葡萄球菌引起的感染；对青霉素过敏患者的细菌性心内膜炎；葡萄球菌性小肠结肠炎；接受血液透析患者的葡萄球菌感染；耐青霉素类白喉杆菌引起的感染；以及对人工瓣膜患者或青霉素过敏患者的细菌性心内膜炎预防。它可渗透到脑脊液中，这表明万古霉素可能对治疗某些中枢神经系统感染有用。尽管其耳毒性和肾毒性潜力不可忽视，但通过将血清浓度维持在适当水平，这些问题可以降到最低。
