Type of Medication: Antibiotic

Indications: Treatment of infections due to sensitive Gram positive and negative organisms. Good activity against H. influenzae.

Side Effects: Nephrotoxic (including renal failure and interstitial nephritis), ototoxicity (discontinue if tinnitus occurs), blood disorders (including neutropenia), nausea, chills, fever, eosinophilia, anaphylaxis, rashes (including exfoliative dermatitis, Stevens- Johnson syndrome, TEN and vasculitis), phlebitis, wheezy, dyspnoea, severe hypotension, urticaria, pruritus, flushing of the upper body (red man syndrome), muscle spasm of back and neck.

Route of administration:Adult (Intravenous)

Dose:1 g every 12 hours. Adjust dose or frequency of administration according to plasma concentrations.If impaired renal function give a single dose of 1 gm and repeat when trough level < 10 mg/l

Administration: Slow infusion maximum rate of 10 mg per minute, imperative to avoid hypotension and possible shock and red man syndrome. Plasma concentration monitoring required. Pre-dose (trough) concentration should be 10-15 mg /L.

Route of administration: Adult (Oral)

Dose:125 mg qds for 7 to 10 days in C difficile colitis. Try metronidazole first line. Longer treatment required in severe cases

Route of administration: Paediatric (Intravenous)

Dose:1 month – 18 years: 15 mg/kg every 8 hours (maximum daily dose 2 g ). Adjust dose according to plasma concentrations.

Administration: as per adults

Route of administration: Paediatric (Oral)

Dose:Antiboitic associated colitis: 1 month – 5 years: 5 mg/kg four times a day for 7 – 10 days. 5 – 12 years: 62.5 mg four times a day for 7 – 10 days. 12- 18 years: 125 mg four times a day for 7 – 10 days.

Examples of some Drug Interactions

Interacting drug: Aminoglycosides

increased risk of nephrotoxicity and ototoxicity

Interacting drug: Amphotericin

increased risk of nephrotoxicity

Interacting drug: Anaesthetic agents

hypersensitivity reactions

Interacting drug: Cholestyramine

antagonises oral vancomycin

Interacting drug: Colomycin

increased risk of nephrotoxicity

Interacting drug: Loop diuretics

increased risk of ototoxicity