There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.
From the FDA Drug Label
- Contraindications: The FDA drug label states that vancomycin hydrochloride for injection is contraindicated in patients with:
- Known hypersensitivity to this antibiotic 1
- Answer: Vancomycin is contraindicated in patients with known hypersensitivity to this antibiotic.
From the Research
Contraindications to Vancomycin
The provided studies do not explicitly list contraindications to vancomycin. However, we can infer some potential contraindications based on the adverse effects and toxicity associated with vancomycin use:
- Hypersensitivity reactions: patients with a known allergy to vancomycin should avoid its use 2, 3
- Nephrotoxicity and ototoxicity: patients with pre-existing renal or hearing impairment should be cautious when using vancomycin, and monitoring of serum concentrations and renal function is recommended 2, 4, 5
- Red man syndrome: this is a common adverse effect of vancomycin, and patients who have experienced this reaction in the past may want to avoid vancomycin use 2, 5
Special Considerations
Some patient populations may require special consideration when using vancomycin:
- Patients with renal dysfunction: vancomycin is primarily excreted by the kidneys, and patients with renal impairment may be at increased risk of nephrotoxicity 4, 5
- Patients with hepatic dysfunction: vancomycin may be metabolized by the liver, and patients with hepatic impairment may be at increased risk of toxicity 5
- Patients with hypertension or diabetes: these patients may be at increased risk of adverse effects, such as nephrotoxicity and red man syndrome 5
Administration Precautions
To minimize the risk of adverse effects and toxicity, vancomycin should be administered with caution:
- Avoid rapid infusion rates, as this can increase the risk of red man syndrome and other adverse effects 4, 3
- Monitor serum concentrations and renal function regularly, especially in patients with renal impairment 2, 4, 5
- Use the minimum effective dose and duration of therapy to minimize the risk of toxicity and resistance 2, 6