Glycopeptides are antibiotics primarily used to treat skin infections such as erysipelas, cellulitis, wound infections, and skin abscesses caused by gram-positive bacteria.
Additionally, some glycopeptides can be used to treat staphylococcal enterocolitis, gastrointestinal Clostridioides difficile infection, joint or bone infections, and other serious infections like pneumonia, endocarditis, bacteriemia, and septicemia.
Glycopeptides work well against Staphylococcus epidermidis, Staphylococcus agalactiae, Staphylococcus aureus, especially the methicillin-resistant type called MRSA, as well as Streptococcus pneumoniae, Streptococcus pyogenes, and vancomycin susceptible Enterococcus faecalis.
There are four medications in this group: vancomycin, telavancin, dalbavancin, and oritavancin. All glycopeptides are administered intravenously, while vancomycin can also be given orally.
Once administered, glycopeptides inhibit bacterial cell wall synthesis by interfering with peptidoglycan polymerization and cross-linking, ultimately causing bacterial cell death.
Common side effects of glycopeptides include ototoxicity, injection site reactions, and gastrointestinal disturbances like nausea, vomiting, and diarrhea.
In some cases, glycopeptides can disrupt the healthy intestinal flora and allow resistant bacteria to overgrow, which may result in superinfection, such as Clostridioides difficile infection or CDI for short. For treatment, CDI and staphylococcal enterocolitis are the only indications for oral vancomycin.