藥品新增

<21V112>Vancomycin (Vancover®) (125mg).膠囊

新藥介紹

<21V112>Vancomycin (Vancover®) (125mg).膠囊

藥理作用/作用機轉

Inhibits bacterial cell wall synthesis by blocking glycopeptide polymerization through binding tightly to D-alanyl-D-alanine portion of cell wall precursor.

適應症/

劑量

PO

【Adult】

　●Clostridioides difficile infection, prophylaxis: 125 mg QD; continue for 5 to 7 days after completion of systemic antibiotics.

　●Clostridioides difficile infection, treatment: 125 mg QID. Usual duration is 10 days, a longer duration (eg, up to 14 days) may be considered. Other regimen: See UPTODATE.

　　*Fulminant infection (ie, ileus, megacolon, and/or hypotension/shock): 500 mg QID with IV metronidazole. Usual duration is 10 days; a longer duration (eg, up to 14 days) may be considered.

【Pediatric】

　●C. difficile infection; treatment: 10 mg/kg/dose QID for 10 days; maximum dose: 500 mg/dose; may consider adding IV metronidazole in critically ill patients.

【Geriatric】Refer to adult dosing.

『Renal Impairment: Adult』

No dosage adjustment provided.

『Hepatic Impairment: Adult』

No dosage adjustment provided

使用禁忌

Hypersensitivity to vancomycin or any component of the formulation.

警告/預防

Superinfection

不良反應

【>10%】Hypokalemia, abdominal pain, nausea

【1% to 10%】Peripheral edema, diarrhea, flatulence, vomiting, UTI, fatigue, headache, back pain, nephrotoxicity, fever

【Frequency not defined】Hypotension, constipation, anemia, depression, insomnia, increased serum creatinine, renal failure syndrome, renal insufficiency

【Postmarketing】Vasculitis, acute generalized exanthematous pustulosis, dermatologic disorder, exfoliative dermatitis, pruritus, skin rash, SJS/TEN, urticaria, eosinophilia, thrombocytopenia, anaphylaxis, flushing, nonimmune anaphylaxis, drug reaction with eosinophilia and systemic symptoms, chills, dizziness, drug fever, pain, vertigo, muscle spasm (chest and back), tinnitus, dyspnea, wheezing

懷孕用藥分級(FDA)

C /避免使用，除非有治療必要

健保規範

  • 藥品說明：申報時應檢附下列報告之一：(1)內視鏡檢查報告。(2)臨床症狀敘述，加上Toxin A+B檢測報告、糞便細菌培養結果、糞便細菌抗原檢測(GDH)結果或PCR基因檢測結果。

  • 藥品理由：梭狀桿菌引起之假膜性結腸炎

其他

Vancomycin is recommended for the treatment of mild, moderate, or severe Clostridioides difficile infections in pregnant patients. Standard doses should be used