TB Medications and Vancomycin

TB Medications for asymptomatic tuberculosis, the treatment consists of daily administration of isoniazid (INH) alone for 6 to 12 months to prevent development of the disease.  Patients who are infected with isoniazid drug resistant organisms; there is an alternative treatment of rifampin with pyrazinamide.

Vancomycin is structurally unrelated to other available antibiotics. I V vancomycin is used in the treatment of potentially life threatening infections caused by susceptible organisms that cannot be treated with other less toxic anti-infective agents. It is the drug of choice for methicillin resistant Staphyloccus Aureaus (MRSA), treating positive infections in penicillin allergic patients, and some endocarditis.

However, the C D C reports an increasing percentage of vancomycin resistant enterocci (V R E). Use of vancomycin should be restricted to cases in which it is absolutely necessary, and it should not be used prophylactically.

Although vancomycin is poorly absorbed after oral administration, it is occasionally given orally  to treat G I infections such as pseudomembranous colitis due to overgrowth of C difficile. It is important to note that patients treated with I V vancomycin for systemic infections should not be switched to the oral form (a common practice with other antibiotics), because it is not effective by the oral route for that purpose.

Side effects of vancomycin include

–          Ototoxity or nephrotoxicity with I V use – discontinue with tinnitus, may precede deafness

–          Local effects – give only I V with care, can cause necrosis or thrombophlebitis.

–          Rash, anaphylaxis, vascular collapse

Vancomycin has been used as the last line of defense against staphyloccal infections, as well as for certain streptococcal and enterococcal infections. When you are on vancomycin, kidney function is monitored every two or three days by serum creatinine and B U N.


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