title: The use of vancomycin with its therapeutic and adverse effects: a review.
abstract: OBJECTIVE
  Vancomycin (VCM) is a tricyclic glycopeptide antibiotic produced by Streptococcus orientalis. Widely used in hospitals, it is indicated to fight severe infections caused by Gram-positive bacteria, especially with the advent of MRSA (methicillin-resistant Staphylococcus aureus), penicillin-resistant pneumococci among others. Furthermore, it is indicated for the treatment of patients allergic to penicillins and cephalosporins. Dose recommendations, dilution rates and types of infusion are controversial and also result in toxic effects. Aim of this paper was to perform a literature review showing the therapeutic and adverse effects of vancomycin.
  
  
  METHODS
  This is a literature review of recent articles published on MEDLINE and SciELO databases in English, Portuguese and Spanish.
  
  
  RESULTS
  The main adverse effects of vancomycin are: hypotension, phlebitis, nephrotoxicity, ototoxicity, hypersensitivity reactions, red man syndrome, neutropenia, chills, fever, interstitial nephritis.
  
  
  CONCLUSIONS
  The use of vancomycin is still very common; however, inadequate doses and prolonged therapy pose a risk of increasing minimum inhibitory concentrations (MICs), resulting in subtherapeutic levels, treatment failures and toxicity. Therefore, further studies should be conducted to optimize the administration of vancomycin, monitoring treatments from the beginning in order to ensure a safe and effective use of the drug.
authors.affiliation: Discipline of Pharmacology, Morphology Department, Faculdade de Medicina do ABC, Santo André, Brazil. filo_bruniera@hotmail.com.
authors.forename: F R
authors.initials: FR
authors.lastname: Bruniera
authors.forename: F M
authors.initials: FM
authors.lastname: Ferreira
authors.forename: L R M
authors.initials: LR
authors.lastname: Saviolli
authors.forename: M R
authors.initials: MR
authors.lastname: Bacci
authors.forename: D
authors.initials: D
authors.lastname: Feder
authors.forename: M
authors.initials: M
authors.lastname: da Luz Gonçalves Pedreira
authors.forename: M A
authors.initials: MA
authors.lastname: Sorgini Peterlini
authors.forename: L A
authors.initials: LA
authors.lastname: Azzalis
authors.forename: V B
authors.initials: VB
authors.lastname: Campos Junqueira
authors.forename: F L A
authors.initials: FL
authors.lastname: Fonseca
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use; D006094:Gram-Positive Bacteria / Q000187:drug effects; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D008826:Microbial Sensitivity Tests; D009503:Neutropenia / Q000139:chemically induced; D014640:Vancomycin / Q000009:adverse effects* / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D014640:Vancomycin