Vancomycin, for many of the people who have fallen victim to Methicillin-resistant Staphylococcus aureus (MRSA), it is a final solution. Vancomycin is a glycopeptide antibiotic. It is the solution of last resort but highly effective.
Vancomycin is used to treat bacterial infections by stopping or killing the bacteria responsible. When treatment using other antibiotics has failed, Vancomycin is the strongest option available. The antibiotic is available in capsule and injection form, although oral Vancomycin is not effective against MRSA.
The advantage of capsules is that generally they are not absorbed into the blood stream. It is argued that because of this Vancomycin in capsule form is unlikely to cause any severe side effects. However, this is precisely where the problem lies. Should the side-effects occur, they have the potential to become quite severe.
Problems Associated With Vancomycin
Nausea, dizziness, feeling cold, flushing, pain, muscle spasms, bruising, the development of a rash, ringing in the ears, hearing difficulties, or breathing problems are all potential risks.
The severity of these side-effects can be variable and immediate medical attention should be sought if any one of the above become apparent whilst taking Vancomycin.
In addition to the above side-effects, Vancomycin is also criticised for being practically and economically troublesome.
The Practical Problem Of Vancomycin
Non-serious MRSA infections, which may include urinary-tract infections (UTI’s), wounds and skin problems, are difficult to treat with Vancomycin. Slow cure rates and even failure cloud the Vanconycin success story.
The Financial Problem Of Vancomycin
Financially, Vancomycin and its course of treatment are somewhat expensive. Particularly in recent years, increasing incidence of MRSA is adding to the National Health Services budgetary commitments. Contributing to the argument against Vancomycin is the toxic issue.
Vancomycin – The Toxic Problem
A particularly significant issue for patients receiving Vancomycin treatment is that the therapy is more toxic than other methicillin-type drugs. Consequently, a patient’s blood levels must be continually monitored.
The Replacement Case – Vancomycin and Linezolid
Rarely does a credible article draw upon the successes and failings of Vancomycin without making some kind of reference to the drug Linezolid. This is because with the emergence of Vancomycin-resistant organisms, increasingly Linezolid has displaced Vancomycin as the drug of last resort. It has always been a concern amongst healthcare leaders and professionals that increasing use of Vancomycin would result in the energence of resistant organisms and this danger has become a reality.
The Case for Linezolid Explained
Linezolid is part of the Oxazolidone antibiotics. It is highly active in vitro against MRSA and additionally it can be taken orally. It is this oral dosing that may permit an earlier discharge of hospitalised patients and what is more Linezolid and Vancomycin have similar clinical efficacy for MRSA infections. So what are the issues surrounding Linezolid?
Problems Associated With Linezolid
With the use of Linezolid comes the risk of haematological abnormalities, including Myelosuppression and Thrombocytopenia. To compound the problem Linezolid is extremely expensive, sometimes more so the Vancomycin.
The prevailing argument appears to be that Linezolid should not be used routinely. That is, to avoid the emergence of Linezolid-resistant Vancomycin-resistant enterococcus (VRE).
The Way Forward for Vancomycin
Vancomycin is a successful drug but with side-effects and associated problems. The spreading of MRSA and the increasing usage of Vancomycin make the drug more susceptible to failure from Vancomycin-resistant organisms. Furthermore, we cannot rely on Linezolid to completely fill the role of Vancomycin. Ultimately, a return to the idea that prevention is better than cure must be encouraged. MRSA prevention programmes are rolling out across the country with the expectation that this will, in time, reduce our dependence on Vancomycin. It is the drug of last resort and should remain so if its effectiveness is to be maintained.