Is Vancomycin a Broad-Spectrum Antibiotic?

Written by

Jessica Guht

Jessica is a medical writer with an unquenched thirst to discover something new. She believes that medical content should be accessible to everyone and strives to write content that every single person can understand. When Jessica isn’t writing, she can usually be found reading a book with a dog cuddled in her lap. Jessica has a Masters of Engineering degree in Biomedical Engineering.

Medically reviewed by

Amy Dougherty, FNP-BC, AGAC

Amy is a Board Certified Family Health Nurse Practitioner (FNP) with over 15 years of experience working in Hospital Medicine, Urgent Care and Primary Care practices. Amy graduated Thomas Jefferson University with high distinction earning a Bachelor of Science in Nursing in 2008, a Master of Science in Nursing in 2010 and a Post Master's Certificate in Adult Gerontology Acute Care (AGAC) in 2014. She was recognized by the Elite American Nurses Association in 2013 for her dedication, achievements and leadership in the field Nursing. She served as a clinical preceptor for a number of Nurse Practitioner students and enjoys teaching the bright minds of future NPs.

Vancomycin is an antibiotic prescribed to treat bacterial infections, and because of its activity in cases of drug resistance, it is often reserved for serious infections. However, is vancomycin considered a broad-spectrum antibiotic?

Although it only treats infections from gram-positive bacteria, Vancomycin is considered broad-spectrum. This is because it still treats a range of infections by bacteria falling within this category. 

As a broad-spectrum antibiotic, doctors can prescribe it earlier since they do not have to be certain of the bacteria causing the infection. 

Key takeaways: 

• Vancomycin is a broad-spectrum antibiotic.
• It belongs to the glycopeptide class of antibiotics.
• It is used to treat infections from gram-positive bacteria.

Continue reading to learn more about vancomycin and what it can be used to treat. 

Table of Contents

• What Exactly Are Broad-Spectrum Antibiotics?
• Is Vancomycin a Broad-Spectrum Antibiotic?
• More About Vancomycin
• Examples of Other Broad-Spectrum Antibiotics
• In Conclusion

What Exactly Are Broad-Spectrum Antibiotics?

Broad-spectrum antibiotics are prescription medications that treat a range of bacterial infections, sometimes spanning both gram-positive and gram-negative bacteria, and other times just congregating within one type. 

Gram-positive and gram-negative are terms used to categorize bacteria based on their outer protection. Gram-negative bacteria have a peptidoglycan layer that is surrounded by an outer membrane. In comparison, gram-positive bacteria have only thick layers of peptidoglycan.

Generally, gram-positive bacteria are easier to kill than gram-negative because the peptidoglycan layers absorb antibiotics. While gram-negative bacteria also have a peptidoglycan layer, its outer membrane repels the antibiotics. 

Even though gram-positive bacteria are considered easier to kill, there are still some strains that are more challenging to rid the body of, often because they exhibit drug resistance. Thus, broad-spectrum antibiotics are invaluable treatments because they can infiltrate many types of bacteria, including those resistant to other types of antibiotics, while others may only be effective against one type. 

Is Vancomycin a Broad-Spectrum Antibiotic?

Vancomycin is a broad-spectrum antibiotic. It shows activity against methicillin-resistant strains of Staphylococcus aureus and is often saved for gram-positive infections that exhibit serious drug resistance. 

Unlike some broad-spectrum antibiotics, vancomycin is only reserved for gram-positive bacterial infections. Still, it treats a wide range of bacteria within this category. 

Since broad-spectrum antibiotics are effective against a broader range of bacterial infections, they can be helpful in cases where an illness could be due to multiple types of bacteria.

Broad-spectrum antibiotics allow you to start treatment even if the doctor does not know the exact bacteria causing the infection, resulting in quicker and less expensive treatment. Additionally, broad-spectrum antibiotics are helpful in cases where someone might be infected by two different bacteria types simultaneously since one antibiotic can clear both infections.  

More About Vancomycin

Vancomycin is an antibiotic belonging to the glycopeptide class of antibiotics. It attacks bacterial infections by inhibiting the linking of amino acid chains in the bacteria. This results in weak cell walls that easily rupture, killing the bacteria. 

When taken orally, vancomycin is only effective in the intestines––oral vancomycin is not usually absorbed into the rest of the body. If the infection is in another part of the body, an injectable form of vancomycin is available. 

Side Effects

Some of the common side effects of vancomycin include:

• nausea
• stomach pain
• low potassium

In some individuals, the body may absorb vancomycin through the intestinal wall. If you have any of the following symptoms, contact your doctor immediately:

• hearing loss
• increased diarrhea that is bloody or watery
• ringing in the ears
• low potassium levels (constipation, leg cramps, fluttering in the chest, irregular heartbeat, numbness or tingling, increased urination or thirst, limp feeling)
• kidney problems (rapid weight gain, swelling, little or no urination, pain in the lower back or side)

In particular, older adults may be more likely to experience any side effects affecting their kidneys. 

Some individuals may also be allergic to vancomycin, which can produce symptoms that include swelling in the lips, face, throat, or tongue, hives, or difficulty breathing. If you experience any of these symptoms while taking vancomycin, seek immediate medical attention. 

Drug Interactions

There are some drugs that may interact with vancomycin, including:

• sulfamethoxazole/trimethoprim (Bactrim)
• ciprofloxacin
• furosemide
• piperacillin/tazobactam (Zosyn)
• adefovir
• diatrizoate

There are also five diseases that can interact negatively with vancomycin: ototoxicity, colitis, renal dysfunction, GI inflammation, and neutropenia. 

Examples of Other Broad-Spectrum Antibiotics

There are many antibiotics considered broad-spectrum, some of which include:

• ampicillin
• doxycycline
• minocycline
• azithromycin
• carbapenems
• quinolones
• tetracyclines (except sarecycline)
• aminoglycosides (except streptomycin)
• piperacillin and piperacillin/tazobactam
• chloramphenicol
• trimethoprim/sulfamethoxazole
• ofloxacin

In Conclusion

Vancomycin is an antibiotic prescribed to treat bacterial infections. When taken orally, it is only effective in the intestines, but it is also available as an injection that can be targeted to the problem areas. 

One feature of vancomycin is its activity as a broad-spectrum antibiotic, which means that it is effective against a large number of bacterial infections by gram-positive bacteria, or bacteria with a thick peptidoglycan layer as part of their cell wall. This layer easily absorbs vancomycin, and then the antibiotic causes the cell walls to develop holes that can easily rupture.

While vancomycin is only effective against gram-positive bacteria, it shows activity against strains of Staphylococcus aureus resistant to methicillin. So, it is often saved for serious gram-positive infections displaying drug resistance. 

Sources:

• Antonoplis, A., Zang, X., Wegner, T., Wender, P. A., & Cegelski, L. (2019). Vancomycin-Arginine Conjugate Inhibits Growth of Carbapenem-Resistant E. coli and Targets Cell-Wall Synthesis. ACS chemical biology, 14(9), 2065–2070. https://doi.org/10.1021/acschembio.9b00565
• Patel S, Preuss CV, Bernice F. Vancomycin. [Updated 2023 Mar 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459263/
• LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Vancomycin. [Updated 2020 Aug 20]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK548881/
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• Mühlberg, E., Umstätter, F., Kleist, C., Domhan, C., Mier, W., & Uhl, P. (2020). Canadian Journal of Microbiology, 66(1), 11–16. doi: https://www.doi.org/10.1139/cjm-2019-0309