Vancomycin
Vancomycin. Glycopeptide antibiotic — binds D-Ala-D-Ala terminus of peptidoglycan precursors blocking transpeptidation. Workhorse against MRSA +… IV half-life 6.6 h.
Glycopeptide antibiotic — binds D-Ala-D-Ala terminus of peptidoglycan precursors blocking transpeptidation. Workhorse against MRSA + severe gram-positive infections. IV for systemic; PO for C. difficile colitis (not absorbed). Nephrotoxicity + ototoxicity require trough monitoring.
PK: THE WRONG ARM OF A TWO-ARM STUDY, AND THE ARM CHOSEN WAS THE INTERVENTION. Its citation reads "Mean CONTROL values ... were 6.4 +/- 1.0 liters/h, 6.6 +/- 1.5 h ... Mean values for the same parameters were 6.4 +/- 1.0 liters/h, 6.0 +/- 0.9 h ... WHEN ACTIVATED CHARCOAL WAS GIVEN", and the record stored the charcoal figure. Ten percent is small; the SHAPE is exactly the recurring one. The volume was not in that abstract at all and had been back-derived against a half-life matching neither arm. Both halves are now anchored to the control arm, and the clearance the pair implies equals the paper own verbatim figure exactly. A PHYSICAL SANITY CHECK PASSES: at one gram twice daily the model reproduces the KNOWN INADEQUACY of that regimen against the standard exposure target, which is a real property of the drug rather than a defect. MY PER-KILOGRAM DOSE PRIOR IS REFUTED HERE — the stored doses ARE the seventy-kilogram equivalents of the standard weight-based regimen, which is the correct workaround for a schema with no weight-based unit, and it is precisely the eleven records storing the RAW per-kilogram number that are wrong. An oral route declared with no parameters is removed; I CHECKED WHETHER IT SILENTLY FELL THROUGH TO THE DEFAULTS AND IT DID NOT — the resolver returns nothing without an elimination rate, so the route was dead rather than dangerous, but the dosing interface keys off the declared list.
Pharmacokinetics
- IV — t½ 6.6 h · F 100% · Vd 60.9 L
Sources: PMID:3606073