Hermans P E, Wilhelm M P
Division of Infectious Diseases and Internal Medicine, Mayo Clinic Jacksonville, Florida.
Mayo Clin Proc. 1987 Oct;62(10):901-5. doi: 10.1016/s0025-6196(12)65046-0.
Vancomycin is a narrow-spectrum bactericidal antibiotic used primarily for treatment of serious staphylococcal infections. It is the alternative therapy of choice when the penicillins and cephalosporins cannot be used. Vancomycin is also used in (1) methicillin-resistant Staphylococcus aureus infections; (2) streptococcal endocarditis in conjunction with an aminoglycoside in patients intolerant of penicillin or ampicillin; (3) infections, including those involving prosthetic devices, caused by gram-positive organisms with multiple antibiotic resistance; (4) antibiotic-induced enterocolitis caused by Clostridium difficile; and (5) prophylaxis for endocarditis in patients who are at risk and cannot tolerate a penicillin, cephalosporin, or erythromycin. The major toxic effect associated with the use of vancomycin is ototoxicity, which may develop when serum levels exceed 30 micrograms/ml.
万古霉素是一种窄谱杀菌性抗生素，主要用于治疗严重的葡萄球菌感染。当不能使用青霉素和头孢菌素时，它是可供选择的治疗药物。万古霉素还用于：（1）耐甲氧西林金黄色葡萄球菌感染；（2）对青霉素或氨苄西林不耐受的患者并发氨基糖苷类药物治疗链球菌性心内膜炎；（3）由多重耐药革兰氏阳性菌引起的感染，包括涉及人工装置的感染；（4）艰难梭菌引起的抗生素相关性小肠结肠炎；（5）对有风险且不能耐受青霉素、头孢菌素或红霉素的患者进行心内膜炎的预防。使用万古霉素的主要毒性作用是耳毒性，当血清水平超过30微克/毫升时可能会发生。
