Glycopeptides

Question 1

Vancomycin
- Resistance Mechanism

Answer 1

VanA inhibits vancomycin binding binding to peptidoglycan

Modified peptidoglycan precursors

S. Aureus (Thick cell wall from accumulation of peptidoglycan cell wall)

Question 2

VanA

Answer 2

Resistant to:
- High Level Vancomycin
- Teicoplanin

Question 3

VanB

Answer 3

Resistant to:
- Vancomycin

Susceptible to:
- Teicoplanin

Question 4

VanC

Answer 4

Resistant to:
- Low level Vancomycin

Susceptible to:
- Teicoplanin

Question 5

Vancomycin
- Adverse Effects

Answer 5

Infusion reactions if given too quickly
- Fever, chills, phlebitis

Reversible Nephrotoxicity (Common with aminoglycosides)

Irreversible Otoxicity

Question 6

Teicoplanin
- Adverse Effects

Answer 6

No infusion reaction

Less Otoxicity

Less Nephrotoxicity

Question 7

Telavancin
- Adverse Effects

Answer 7

Avoid in pneumonia + renal impairment

Avoid in pregnancy

Question 8

Telavancin
- Counseling

Answer 8

May be used in patients who failed Vancomycin treatment

Patients with MRSA infections after vancomycin

Question 9

Dalbavancin
- Counseling

Answer 9

Used against almost all Gram-Positive Bacteria

• No activity against VanA
• Activity against VanB (maybe)
• Activity against VanC

Question 10

Oritavancin
- Counseling

Answer 10

Good activity against almost all Gram-Positive Bacteria