Understanding the Purpose of Oral Vancomycin
Unlike the intravenous (IV) form of vancomycin, which treats serious systemic infections like MRSA, oral vancomycin is poorly absorbed into the bloodstream. This allows it to remain concentrated in the gastrointestinal (GI) tract, where it targets specific bacterial infections. Its primary purpose is to treat intestinal conditions, most notably:
- Clostridioides difficile-associated diarrhea (CDAD): Often referred to as C. diff, this infection can cause severe diarrhea and colitis.
- Staphylococcal enterocolitis: Inflammation of the lining of the small intestine caused by certain Staphylococcus bacteria.
Because oral vancomycin's effect is confined to the gut, it is an ineffective treatment for any other type of infection.
How to Properly Administer Your Dose
Adhering to your doctor's instructions and the directions on your prescription label is critical for effective treatment. Vancomycin is available in both capsule and oral solution forms, and administration differs slightly for each.
If you are prescribed vancomycin capsules:
- Swallow the capsule whole with a full glass of water.
- Do not crush, chew, or break the capsule, as this could affect its efficacy.
- You can take the capsules with or without food. If you experience stomach upset, taking them with food may help ease symptoms.
If you are prescribed vancomycin oral solution:
- Shake the bottle well before each use to ensure the medication is evenly mixed.
- Use a specially marked oral syringe, measuring spoon, or medicine cup provided by your pharmacist to measure the exact dose. Never use a household teaspoon, as it is inaccurate.
- Store the oral solution in the refrigerator after it has been prepared. It must be discarded after 14 days, or sooner if specified by your pharmacist.
Understanding the Administration Regimen
Your specific administration schedule and treatment length depend on the infection and its severity, as determined by your healthcare provider. Vancomycin is typically taken multiple times throughout the day.
For many initial episodes of C. difficile, a common approach involves taking a specific dose at regular intervals for a set duration. However, a doctor may prescribe a different regimen, including using the 250 mg strength, for more severe or complicated cases of C. difficile or for staphylococcal enterocolitis.
Regardless of your specific prescription:
- Take your doses at evenly spaced intervals throughout the day as directed by your doctor or pharmacist to maintain a consistent level of the antibiotic in your gut.
- Do not stop taking the medication, even if your symptoms improve. Finishing the full course is essential to fully eliminate the infection and prevent relapse and the development of antibiotic resistance.
Vancomycin Administration: Oral vs. Intravenous
Understanding the key differences between oral and intravenous (IV) administration of vancomycin is vital, as they are used for completely different types of infections. Oral vancomycin targets infections within the gut, whereas IV vancomycin treats infections that have entered the bloodstream or are located in other areas of the body.
| Feature | Oral Vancomycin | Intravenous (IV) Vancomycin |
|---|---|---|
| Administration Method | Taken by mouth via capsule or oral solution | Injected directly into a vein |
| Target Area | Localized to the intestinal tract | Distributes throughout the entire body |
| Systemic Absorption | Poorly absorbed; stays mostly in the gut | Highly absorbed; achieves therapeutic blood levels |
| Primary Use | C. difficile-associated diarrhea and staphylococcal enterocolitis | MRSA and other severe systemic infections, like pneumonia, endocarditis, and bone infections |
| Effective For GI Infections? | Yes, highly effective | No, ineffective for C. difficile because it doesn't reach the gut in sufficient concentrations |
Potential Side Effects and Precautions
Oral vancomycin is generally well-tolerated, but some side effects can occur. Most are minor, but some may indicate a more serious issue.
Common Side Effects:
- Gas
- Headache
- Nausea and vomiting
- Back pain
- Stomach pain
Serious Side Effects (Contact your doctor immediately if you experience these):
- Allergic reactions, such as hives, rash, severe itching, or swelling of the face, tongue, or throat
- Signs of kidney problems, including decreased urination or unusual swelling of the arms, hands, legs, or feet
- Hearing changes, such as ringing in the ears (tinnitus), dizziness, or hearing loss
- Signs of serious skin reactions, like a sore throat, fever, or blistering
It is also important to tell your doctor and pharmacist about any other medications, supplements, or herbal products you are taking, as drug interactions are possible. For example, avoid taking cholesterol-lowering medications like cholestyramine or colestipol within 3-4 hours of your oral vancomycin dose.
Conclusion
Taking oral vancomycin requires careful adherence to your healthcare provider's instructions. Remember to complete the entire course of medication, even if your symptoms start to improve. By understanding its specific purpose for intestinal infections and properly administering your doses at the prescribed times, you can maximize its effectiveness and minimize the risk of complications and the development of antibiotic resistance. If you have any concerns or experience serious side effects, contact your doctor or pharmacist promptly.
For more information on Clostridioides difficile infection, visit the Centers for Disease Control and Prevention website.
