Vancomycin for Clostridioides difficile

About vancomycin

Vancomycin is used to a treat a bacterial infection in your bowel caused by Clostridioides difficile (C. difficile). Infection with C. difficile most commonly occurs in people who have recently had a course of antibiotics and are in hospital.

Some people have small numbers of C. difficile germs (bacteria) which live in their bowels, and they usually do no harm. This is because the number of C. difficile bacteria living in the gut of healthy people is kept in check by other harmless bacteria that also live in the gut. However, if the number of C. difficile bacteria increases, then it can cause problems. The most common reason why this occurs is due to taking antibiotics. As well as killing the bacteria that are causing an infection, antibiotics also kill many of the harmless bacteria that live in your gut. This allows the number of C. difficile bacteria to increase.

Symptoms of C. difficile infection can range from mild diarrhoea to a life-threatening inflammation of the bowel. No treatment may be needed in mild cases except drinking plenty of fluids. However, treatment with specific antibiotics like vancomycin is needed in more severe cases. Vancomycin works by stopping the growth of C. difficile bacteria.

Before taking vancomycin

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking vancomycin it is important that your doctor knows:

• If you are pregnant or breastfeeding.

• If you have problems with your ears, such as any deafness.

• If you have an inflammatory bowel disorder.

• If you have any problems with the way your kidneys work.

• If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

• If you have ever had an allergic reaction to a medicine.

How to take vancomycin

• Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about vancomycin, and will also provide you with a full list of the side-effects which you could experience from taking it.

• Take the capsules exactly as your doctor tells you to. It is usual to take one (125 mg) capsule four times a day for 10-14 days. In serious infections, the dose could be as high as 500 mg four times a day for 10-14 days. Your doctor will tell you what dose is right for you, and this information will also be printed on the label of the pack of capsules to remind you about what the doctor said to you.

• Try to space your doses out evenly throughout the day, so ideally, take a dose every six hours. Continue to take the capsules until the full course is finished - if you stop too soon, your infection may return and could be more difficult to treat.

• You can take the capsules either with or without food.

• If you forget to take a dose, take it as soon as you remember. Try to take the correct number of doses each day but do not take two doses at the same time to make up for a missed dose.

Getting the most from your treatment

• Drinking plenty of fluids is very important if you have diarrhoea. Your doctor will advise you about how much and what type of fluids you should drink.

• Try to keep any scheduled appointments with your doctor. This is so your doctor can check on your progress. Your doctor may want to do some blood tests during the treatment.

• You, and those caring for you, need to follow strict hygiene measures. This will help to prevent the spread of infection to others. You should regularly wash your hands thoroughly, especially after each time you have been to the toilet. Your doctor will advise you about any other measures needed.

• If you are having an operation or any medical tests, tell the person carrying out the treatment that you are taking vancomycin.

• This antibiotic can stop the oral typhoid vaccine from working. If you are having any vaccinations, make sure the person treating you knows that you are taking it.

• If you buy any medicines, check with a pharmacist that they are suitable to take with your other medicines.

Can vancomycin cause problems?

Vancomycin capsules are generally not absorbed into your bloodstream and are therefore unlikely to cause any side-effects. You may be more at risk of the medicine getting into your bloodstream (and hence more at risk of side-effects) if you have an inflammatory bowel condition. Your doctor will monitor to see how much of the vancomycin gets into your bloodstream, and will tell you what the side-effects could be if this happens.

If you experience any symptoms which you think could be due to the capsules, please speak with your doctor or pharmacist for advice.

How to store vancomycin

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.

• If you have been given the oral liquid medicine it must be stored in the fridge and used within four days (96 hours).

Important information about all medicines