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Other cell wall synthesis inhibitors, Antibacterial spectrum of vancomycin…
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Telavancin
• Similar activity to vancomycin with activity against some vancomycin-resistant strains of Enterococcus
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has been approved for complicated skin and skin structure infections.
It is effective against MRSA.
Apart from vancomycin like mechanism it also disrupts membrane potential.
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Fosfomycin
• Excellent activity vs. E. coli, Proteus, Enterococcus
• Some activity vs. Klebsiella, Enterobacter
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inhibits cell wall synthesis by inhibiting enolpyruvate transferase.
Diarrhea is quite common with its use.
It is drug of choice along with nitrofurantoin for uncomplicated urinary tract infections.
Bacitracin
also inhibits cell wall synthesis.
But because of marked nephrotoxicity, it is indicated only for topical use.
It is selectively active against gram positive bacteria.
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Cycloserine
also inhibits cell wall synthesis.
It has potential neurotoxic effects(tremors and seizures).
It can also causes neuropsychiatric symptoms.
One of the second line drug for the treatment of tuberculosis.
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Teicoplanin
Teicoplanin is another glycopeptide with similar characteristics
but can be given once daily due to long half life(45-70 hours).
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Red man syndrome
Rapid IV infusion of high doses of vancomycin can cause red man syndrome
due to diffuse flushing because of histamine release.
Most common adverse reaction to vancomycin.
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Uses of oral vancomycin
Vancomycin is used orally to treat pseudomembranous colitis by clostridium difficle
because it is not absorbed from the gastrointestinal tract
and higher concentration reaches the colon.