Glycopeptides

Vancomycin: Vancomycin is active against Staphylococcus aureus. Staphylococ­cus epidermidis, including strains resistant to methicillin (therefore also oxacillin and cloxacillin). Other Gram-positive bacteria such as Streptococcus pyogenes, Strep­tococcus pneumoniae, enterococci, Corynebacterium jeikeium, and Clostridium difficile are all sensitive to vancomycin. Ototoxicity, nephrotoxicity, allergy and,  when infused rap-idly, "red-man syndrome" (erythroderma and hypotension), are principal adverse effects. Vancomycin is not absorbed from the gastrointestinal tract. As an IV infusion, it is the antibiotic of choice for the treatment of serious methicillin/oxacillin-resistant staphylococcal infections. ln the penicillin-allergic patient it is used in combination with an aminoglycoside for the treatment of enterococcal endocarditis. Given orally, vancomycin is an alternative to metron­idazole for the treatment of pseudomembranous colitis.

- Teicoplanin: Teicoplanin is o glycopeptide antibiotic with o molecular structure related to that of vancomycin. Gram-positive bacteria such as staphylococci (including methicillin-resistant strains), streptococci, enterococci and many anaer­obic Gram-positive bacteria are susceptible to teicoplanin in vitro. Rare species of coagulase-negative staphylococci may be resistant to teicoplanin yet sensitive to vancomycin. Teicoplanin hos an exceptionally long half-life, allowing once-daily intramuscular or intra-venous administration. Teicoplanin has been in clinical use for o shorter period than hos been vancomycin, and is regarded by some as an alternative glycopeptide to vancomycin.