A glycopeptide antibiotic
Vancomycin
A glycopeptide antibiotic given into a vein for serious infections, or by mouth for C. difficile.
What is Vancomycin?
Vancomycin is a glycopeptide antibiotic used for serious bacterial infections, including MRSA. It is given into a vein for infections in the body, or by mouth specifically to treat Clostridioides difficile (C. difficile) infection of the bowel. The intravenous form needs kidney and blood-level monitoring and must be infused slowly.
Education and reference only. This is a plain-language guide to Vancomycin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Vancomycin is a glycopeptide antibiotic used mainly in hospital for serious infections caused by Gram-positive bacteria, including MRSA. Given into a vein it treats infections throughout the body; taken by mouth it stays in the gut and is used to treat C. difficile, a cause of severe antibiotic-associated diarrhoea.
How it works
Vancomycin works by stopping bacteria from building their cell walls. It binds to the building blocks bacteria use to construct the wall, so the wall cannot form properly and the bacteria break apart and die. This makes it effective against many Gram-positive bacteria, including some that resist other antibiotics.
Company & origin
Originated / developed by: Available as a generic medicine from several manufacturers..
In use since the 1950s and a mainstay in UK hospitals for serious resistant infections.
Practical use
How to take Vancomycin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- The intravenous form is given by infusion in hospital, slowly to avoid a flushing reaction.
- For C. difficile, take the oral form by mouth exactly as directed.
- Complete the full course even if you feel better.
- Drink enough fluids unless told otherwise, to help protect the kidneys.
- Report flushing, rash, hearing changes or reduced urine output promptly.
- Do not assume the oral form treats infections elsewhere in the body; it acts in the gut.
Weighing it up
Advantages & disadvantages of Vancomycin
Advantages
- Effective against serious Gram-positive infections, including MRSA.
- The oral form is a key treatment for C. difficile bowel infection.
- Long-established with a well-understood safety and monitoring approach.
Disadvantages
- Must be infused slowly to avoid a flushing 'red man' reaction.
- The intravenous form can affect the kidneys and needs blood-level monitoring.
- Can rarely affect hearing, so symptoms must be watched for.
Practical use
Good to know
When vancomycin is given into a vein it must be infused slowly; given too fast it can cause a flushing reaction of the upper body, sometimes called 'red man' syndrome. The intravenous form can affect the kidneys and, rarely, hearing, so your team checks kidney function and blood levels. The oral form used for C. difficile acts in the gut and is barely absorbed.
Who should not take it / use with caution
- People who are allergic to vancomycin.
- People with significant kidney problems need careful dosing and monitoring.
- Those with hearing problems should be assessed, as it can rarely affect hearing.
Monitoring
- Blood levels of vancomycin to keep them effective but not toxic.
- Kidney function before and during intravenous treatment.
- Hearing and infusion reactions, with prompt review if symptoms appear.
Side effects
- Flushing of the upper body if infused too quickly ('red man' reaction).
- Effects on the kidneys, shown by blood tests.
- Rarely, hearing changes or ringing in the ears.
Key interactions
- Other medicines that affect the kidneys or hearing add to the risk of harm.
- Some anaesthetic agents can increase infusion reactions.
- Tell your team about all medicines so risks can be managed.
Available as: Available as an injection/infusion and as capsules or a solution taken by mouth.
Answers
Vancomycin: frequently asked questions
What is 'red man' syndrome?
It is a flushing reaction of the face and upper body that can happen if vancomycin is infused too quickly. Giving the infusion slowly usually prevents it.
Why is the oral form used for C. difficile?
Taken by mouth, vancomycin stays in the gut and is barely absorbed, so it acts right where C. difficile is causing infection in the bowel.
Why are blood levels checked?
The intravenous form needs to stay within a safe range. Monitoring levels keeps it effective while protecting the kidneys and hearing.
Can vancomycin treat MRSA?
Yes. It is a mainstay treatment for serious MRSA and other resistant Gram-positive infections, usually given into a vein in hospital.
Does the oral form treat infections in the blood?
No. The oral form acts in the gut and is barely absorbed, so it is used for C. difficile, not for infections elsewhere in the body.
The wider class
About Glycopeptide antibiotics
Vancomycin belongs to the glycopeptide antibiotics class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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