Overview
What Vancomycin Treats—and Where It Works
Vancomycin is a glycopeptide antibiotic that kills susceptible gram positive bacteria by binding to the D alanine D alanine termini of peptidoglycan precursors.
Vancomycin is a glycopeptide antibiotic that kills susceptible gram-positive bacteria by binding to the D-alanine-D-alanine termini of peptidoglycan precursors. This blocks bacterial cell-wall synthesis. It is therefore used for severe or life-threatening infections such as methicillin-resistant *Staphylococcus aureus* (MRSA) bacteremia, endocarditis, osteomyelitis, and pneumonia. The route matters as much as the drug. Intravenous vancomycin is used when infection is systemic because oral vancomycin has negligible systemic absorption. Oral therapy acts within the gastrointestinal tract and is used for *Clostridioides difficile* colitis; it should not be substituted for intravenous treatment of bacteremia, endocarditis, pneumonia, or other invasive infection.