What are the Vancomycin Side Effects?

Vancomycin is an effective antibiotic that treats severe bacterial infections, especially those caused by Gram-positive bacteria such as Staphylococcus aureus (including methicillin-resistant Staphylococcus aureus, or MRSA).

It is effective by inhibiting the production of the bacterial cell wall, leading to bacterial death. Vancomycin is a critical agent used for many infections, but it does have adverse effects, several of which are severe. Knowledge of these effects and ways to minimize them is indispensable for both patients and health personnel.

Side Effects of Vancomycin with a Code Icon: Vancomycin Side Effects Hearing Loss

As with all medicines, vancomycin can cause side effects, but not everyone gets them. The most frequent side effects are typically mild, including:

Red Man Syndrome: “Red Man Syndrome” is one of the most prominent side effects of vancomycin, and it occurs when the drug is infused too quickly. The syndrome is associated with a rash and facial flushing, which the individual may notice as their face, neck, and upper chest area become red.

Severe cases may lead to hypotension (low blood pressure), dizziness, and even fainting. It is not an allergy but the rapid release of histamine (Red Man Syndrome). The symptoms can often be remedied by reducing the rate of administration.

GI problems: Nausea, vomiting, and diarrhea are common GI side effects of vancomycin. These symptoms are usually mild but can be irritating. Long-term use of vancomycin may in turn upset the balance of bacteria within the gut; this can lead to Clostridium difficile (C. difficile) infection, a serious condition that causes diarrhea and colitis.

Injection Site Pain: Vancomycin given into the vein can cause pain, irritation, or swelling at the site of injection. This occurs more frequently when the drug is given too rapidly.

Vancomycin has some serious adverse effects

Although many side effects of vancomycin can be addressed, there are also some so severe that medical intervention is needed right away. These include:

Renal Toxicity (Nephrotoxicity): Vancomycin can damage the kidneys, especially renal toxicity, which occurs with increased doses or when used for a longer time. It can result in acute kidney injury (AKI), a situation that may be fatal if not quickly addressed.

Vancomycin is often monitored by changes in kidney function (blood urea nitrogen [BUN] and serum creatinine levels) during therapy. Patients with previous kidney disease, dehydrated patients, and concomitant use of other nephrotoxic drugs are at higher risk for renal injury.

Hearing Loss (Ototoxicity)—Vancomycin can lead to hearing loss too, and it occurs more often when used in dangerously elevated doses or with other ototoxic drugs (e.g., some antibiotics, including aminoglycosides). Ototoxicity causes reversible and irreversible hearing impairment in the inner ear or auditory nerve. More so in patients with hearing loss or elderly.

Hypersensitivity Reactions: Although infrequent, some persons may suffer hypersensitivity to vancomycin. Allergic reactions can occur with mild symptoms such as rashes and itching or more severe symptoms such as breathing difficulties, swelling of the face or throat (angioedema), and/or anaphylaxis. Anaphylaxis: Serious allergic reactions like anaphylaxis require immediate treatment.

Rarely, it interferes with the number of blood cells in the body, creating problems such as leukopenia (low white blood count) or thrombocytopenia (low platelets). These may strengthen the chance of an infection or bleeding. During treatment, blood tests are usually done to keep track of the effects on the blood counts from vancomycin.

Side Effects of Vancomycin and How to Manage Them

When using vancomycin when prescribed, you should be aware of the side effects as well and take necessary actions to reduce risks. Who says side effects need to be an issue? Some tips on how we can manage & prevent side effects:

Infusion rate management: To prevent Red Man Syndrome, infusion rates are frequently modified by health care practitioners. Using slower infusion rates (which usually take greater than 1 hour for adult patients) minimizes the chances of the reaction. Notify your healthcare team as soon as you experience symptoms like redness, rash, or flushing during the infusion.

Hydration and Renal Function: It is necessary to maintain adequate hydration during vancomycin administration since dehydration increases the risk of nephrotoxicity. Vancomycin is often monitored in blood tests looking for kidney function since the drug can affect this process, and patients with impaired renal function may need to dose adjust on that medication. Patients with any history of kidney disease should alert their physician before beginning therapy with vancomycin.

Hearing: Abstract: Due to the risk of ototoxicity from vancomycin, frequent hearing tests may be prescribed for patients undergoing prolonged and/or high-dose therapy. Notify your doctor immediately if you experience any signs of hearing loss, including tinnitus (ringing in the ears), dizziness, or trouble hearing.

Antibiotic Stewardship: Because the use of vancomycin increases the risk for complications such as difficile infection, judicious and limited use is recommended. Antibiotics can disrupt the natural microbiota of the gut, which may increase susceptibility to secondary infections, or overuse or misuse of antibiotics can lead to antibiotic resistance.

Who Can Get Side Effects From Vancomycin?

Some people are at higher risk of severe side effects from vancomycin, such as:

Patients Over 65 Years of Age: Older adults may have increased risk as aging leads to gradual decline in renal function and sensory systems such that they will be more prone to the effects of nephrotoxicity and ototoxicity. More frequent monitoring or adjustments in dosing might be needed.

Patients with prior renal disease: Patients who have had kidney problems are at greater risk for nephrotoxicity. Consideration should be given to close monitoring of renal function in these patients while using vancomycin.

Patients receiving other ototoxic drugs—co-administration of other medications that may affect the ears, such as aminoglycosides or some chemotherapy agents—increase the risk of hearing loss when vancomycin is added to their regimen.

Conclusion

Vancomycin is a last-resort, life-saving antibiotic used in the treatment of severe bacterial infections, particularly MRSA. But, although a wonder drug, it comes with the risk of side effects—from minor, such as skin irritation, to major adverse events like kidney injury and loss of hearing.

Patients on vancomycin should be monitored closely, and if it is necessary to administer this drug, all measures to reduce the risk of harmful effects (e.g., infusion rate, hydration) or monitoring (kidney function and hearing) should be undertaken [8]. When used properly, vancomycin may be a safe and effective therapy for infections with appropriate management.