Vancomycin

Section 1.1

Midwives may independently prescribe, order and administer this drug.

A glycopeptide anti-infective antibiotic. Inhibits bacterial cell wall synthesis by blocking glycopeptide polymerization which alters cell-membrane permeability.

Indications and Clinical Use:

Intravenous vancomycin is only recommended if client is confirmed to be high risk for anaphylaxis and the isolated GBS is not sensitive to clindamycin. Midwives should consider consultation with a specialist or clinical pharmacist prior initiating GBS prophylaxis with vancomycin.

Contraindications:

Hypersensitivity to Vancomycin or any component of the formulation. Avoid in patients with previous hearing loss.

Warnings and Precautions:

Use with caution in patients with renal impairment. Rapid IV administration may result in erythema, flushing, hypotension, urticaria, and/or pruritus.

Pregnancy:

Compatible

Lactation:

Category L1 – Limited Human Data – Probably Compatible

Small amounts of Vancomycin are excreted in human milk. When given intravenously, the small amount that distributes to the milk would not be expected to cause systemic toxicity due to the lack of GI absorption. Effects could include modification of bowel flora.

Adverse Reactions:

Anaphylaxis, hypotension, pruritus, rash, Stevens-Johnson syndrome, urticaria, vasculitis, nausea, chills, drug fever, hypotension and flushing of the face, neck, upper chest, and extremities.

Dosage and Administration:

IV: 1g q12 hours until delivery.

Onset of Action:

IV: Immediately after completion of infusion

Half-life:

5-11 hours.

Elimination:

Urine (80% to 90% as unchanged drug)