Editing Vancomycin (section)

==Routes of administration==

In the [[United States]], vancomycin is approved by the [[Food and Drug Administration]] for intravenous and oral administration.<ref name="pmid29083794"/>

===Intravenous===
Vancomycin must be given [[intravenous]]ly for systemic therapy since it is poorly absorbed from the intestine. It is a large hydrophilic molecule that partitions poorly across the gastrointestinal [[mucosa]]. Due to its short half-life, it is often injected twice daily.<ref name=VB2006>{{cite journal | vauthors = Van Bambeke F | title = Glycopeptides and glycodepsipeptides in clinical development: a comparative review of their antibacterial spectrum, pharmacokinetics and clinical efficacy | journal = Current Opinion in Investigational Drugs | volume = 7 | issue = 8 | pages = 740–9 | date = August 2006 | pmid = 16955686 }}</ref>

===Oral===
The only approved indication for oral vancomycin therapy is in the treatment of pseudomembranous colitis, where it must be given orally to reach the site of infection in the colon. After oral administration, the fecal concentration of vancomycin is around 500&nbsp;μg/mL<ref name="pmid9314469">{{cite journal | vauthors = Edlund C, Barkholt L, Olsson-Liljequist B, Nord CE | title = Effect of vancomycin on intestinal flora of patients who previously received antimicrobial therapy | journal = Clinical Infectious Diseases | volume = 25 | issue = 3 | pages = 729–32 | date = September 1997 | pmid = 9314469 | doi = 10.1086/513755 | doi-access = free }}</ref> (sensitive strains of ''[[Clostridioides difficile]]'' have a mean inhibitory concentration of ≤2&nbsp;μg/mL<ref name="pmid12019070">{{cite journal | vauthors = Peláez T, Alcalá L, Alonso R, Rodríguez-Créixems M, García-Lechuz JM, Bouza E | title = Reassessment of Clostridium difficile susceptibility to metronidazole and vancomycin | journal = Antimicrobial Agents and Chemotherapy | volume = 46 | issue = 6 | pages = 1647–50 | date = June 2002 | pmid = 12019070 | pmc = 127235 | doi = 10.1128/AAC.46.6.1647-1650.2002 }}</ref>)

===Inhaled (off-label)===
Inhaled vancomycin can also be used [[off-label]],<ref name="pmid31964790">{{cite journal |vauthors=Waterer G, Lord J, Hofmann T, Jouhikainen T |title=Phase I, Dose-Escalating Study of the Safety and Pharmacokinetics of Inhaled Dry-Powder Vancomycin (AeroVanc) in Volunteers and Patients with Cystic Fibrosis: a New Approach to Therapy for Methicillin-Resistant Staphylococcus aureus |journal=Antimicrob Agents Chemother |volume=64 |issue=3 |pages= |date=February 2020 |pmid=31964790 |pmc=7038285 |doi=10.1128/AAC.01776-19 |url=}}</ref> via [[nebulizer]], to treat various infections of the upper and lower respiratory tract.<ref name="pmid25533880">{{cite journal |vauthors=Falagas ME, Trigkidis KK, Vardakas KZ |title=Inhaled antibiotics beyond aminoglycosides, polymyxins and aztreonam: A systematic review |journal=Int J Antimicrob Agents |volume=45 |issue=3 |pages=221–33 |date=March 2015 |pmid=25533880 |doi=10.1016/j.ijantimicag.2014.10.008 |url=}}</ref><ref name="Inhaled-Vancomycin-Monograph">{{cite web|url=https://pch.health.wa.gov.au/~/media/Files/Hospitals/PCH/General-documents/Health-professionals/ChAMP-Monographs/Vanomycin-Inhaled.pdf|title=Inhaled Vancomycin Monograph - Paediatric|publisher=Perth Children's Hospital (PCH)|access-date=19 July 2023|archive-date=14 March 2023|archive-url=https://web.archive.org/web/20230314160643/https://pch.health.wa.gov.au/~/media/Files/Hospitals/PCH/General-documents/Health-professionals/ChAMP-Monographs/Vanomycin-Inhaled.pdf|url-status=live}}</ref><ref name="Palmer-2017">{{cite book|doi=10.1183/1393003.congress-2017.OA4655 |chapter=Eradication of MRSA ventilator-associated infection with inhaled vancomycin |title=Respiratory Infections |year=2017 | vauthors = Palmer LB, Smaldone GC |pages=OA4655 }}</ref><ref name="MRSA-ventilator">{{cite web|url=https://dig.pharmacy.uic.edu/faqs/2020-2/march-2020-faqs/is-there-literature-describing-the-efficacy-or-safety-of-inhaled-vancomycin-to-treat-mrsa-ventilator-associated-tracheobronchitis/|title=Is there literature describing the efficacy or safety of inhaled vancomycin to treat MRSA ventilator-associated tracheobronchitis? &#124; Drug Information Group &#124; University of Illinois Chicago|access-date=19 July 2023|archive-date=19 July 2023|archive-url=https://web.archive.org/web/20230719102710/https://dig.pharmacy.uic.edu/faqs/2020-2/march-2020-faqs/is-there-literature-describing-the-efficacy-or-safety-of-inhaled-vancomycin-to-treat-mrsa-ventilator-associated-tracheobronchitis/|url-status=live}}</ref><ref name="pmid25143711">{{cite journal |vauthors=Zarogoulidis P, Kioumis I, Lampaki S, Organtzis J, Porpodis K, Spyratos D, Pitsiou G, Petridis D, Pataka A, Huang H, Li Q, Yarmus L, Hohenforst-Schmidt W, Pezirkianidis N, Zarogoulidis K |title=Optimization of nebulized delivery of linezolid, daptomycin, and vancomycin aerosol |journal=Drug Des Devel Ther |volume=8 |pages=1065–72 |date=2014 |pmid=25143711 |pmc=4136957 |doi=10.2147/DDDT.S66576 |url= |doi-access=free }}</ref>

===Rectal (off-label)===
Rectal administration is an [[off-label]] use of vancomycin for the treatment of ''[[Clostridioides difficile]]'' infection.<ref name="pmid29083794"/>