II. Indications: Severe Gram Positive Infections
-
Vancomycin-resistant Enterococcus faecium
- Does not cover Enterococcus faecalis
- Methicillin susceptible Staphylococcus Aureus
- Methicillin susceptible Streptococcus Pyogenes
III. Mechanism
- Antibiotic Resistance is rare for its limited indications
-
Anti-Ribosomal Antibiotic
- Binds the Bacterial 50S Ribosomal subunit
IV. Pharmacokinetics
- Hepatic Clearance predominates
- Half-Life: 1-3 hours (9-10 hours of affect)
V. Adverse Effects
- Background
- Adverse effects are common and limit use (other medication options are preferred when available)
- Arthralgias or myalgias (40%)
- Infusion site pain (40%)
- Nausea, Diarrhea or Vomiting
- Hyperbilirubinemia
- Rash or Pruritus
- Headache
VI. Drug Interactions: Metabolized by Cytochrome P-450 3A4
- Raises serum drug levels of substrates in 3A4 system
- Follow Cyclosporine levels when using concurrently
VII. Dosing
- Enterococcus faecium: 7.5 mg/kg IV q8 hours
- Severe Skin Infections: 7.5 mg/kg IV q12 hours
