Vancomycin Powder in High-Risk Infection

Introduction:

Surgical site infections are common post-operative infections that many individuals can experience. It hinders post-surgical recovery and delays wound healing. Several studies showed that diabetic people are at high risk of getting an infection. The common bacterial infections at the surgical site are Methicillin-resistant pathogens and Staphylococcus epidermidis. High-risk surgical procedures, such as heart surgeries and orthopedic surgeries, are associated with high chances of post-surgical infections. To prevent this high-risk infection, several adjunctive measures are explored. One such treatment strategy is the application of Vancomycin powder, which can be applied directly on the surgical site. It is a localized treatment prophylaxis for high-risk infection prevention in the surgical setting. The antimicrobial properties of Vancomycin powder are effective against these infections. The article discusses Vancomycin powder, its application procedure, indications, contraindications, uses, and side effects.

What Is Vancomycin Powder?

Vancomycin powder has antimicrobial and antibacterial properties. The main indication of Vancomycin powder is its local application in the surgical setting. The class to which Vancomycin powder belongs is the glycopeptide class of antibiotics. It is mainly effective against gram-positive bacteria. The mechanism of action of Vancomycin powder obstructs the synthesis process of bacterial cell walls.

Vancomycin is available in the form of powder, liquid, and tablets. It can be given intravenously (through the vein), orally, and topically. The medication is also available in the powder form. The powder form comes in bottles containing a dry version of the drug. The healthcare professional adds a small amount of sterile solution to make it appropriate. This can be used for intravenous infusion. The dose of Vancomycin is based on the patient's weight, renal function, infection type, and severity of infection.

What Is the Procedure for the Application of Vancomycin Powder in High-Risk Infections?

Applying Vancomycin powder in high-risk infections is associated with minimizing the risk of infection. The general overview of the application of Vancomycin powder is as follows:

• Patient Evaluation: Before applying Vancomycin powder, the healthcare provider evaluates the patient and finds the patient at high risk of developing surgical site infections. People undergoing heart surgeries and orthopedic procedures, such as joint replacement surgeries are at high risk of getting surgical site infections. The patient's blood levels are monitored to check efficacy and prevent toxicity. The doctor may ask the patient about their medical history, drug interactions, and any allergy to the drug.

• Vancomycin Powder Preparation: The healthcare provider will prepare the powder using a sterile solution. The dose of Vancomycin powder is based on the surgery type and renal function. The dosage is expressed in grams. Some guidelines recommend applying one to two grams of powder at the surgical site.

• Surgical Site Preparation: The surgical area is prepared by cleaning the surgical site with an aseptic technique. Ensure that the surgical site is free of contaminants.

• Vancomycin Powder Application: After the completion of the surgical site, the Vancomycin powder is sprinkled directly on the surgical area. It decreases the colonization of bacteria in the surgical area. Distribute the Vancomycin powder evenly on the surgical site. The powder dispenser is used to sprinkle the powder.

• Surgical Site Closure: The surgical site is closed with the help of sutures.

• Patient Monitoring: After the surgical procedure, the patient is closely monitored to check for signs of infection.

What Are the Indications of Vancomycin Powder?

The common indications of Vancomycin powder are as follows:

• Orthopedic Surgeries: These surgeries are at high risk of getting infections. Such surgeries include joint replacement surgeries, such as hip and knee replacement surgeries. Other orthopedic surgeries include spinal surgeries.

• Heart Surgeries: Vancomycin powder can be used in case of open heart surgeries to prevent infections.

• Neurosurgical Procedures: The powder can be sprinkled in the case of craniotomy procedures (in case of brain surgeries in which the part of the brain is surgically removed).

• Implant Surgeries: During implant surgeries, such as prosthetic devices, there are more chances of risk of infection. The Vancomycin powder is used to prevent infection.

• Immunocompromised Patients: Individuals with compromised immune systems or a history of bacterial infection are at high risk of post-surgical infections. A Vancomycin powder can be used to prevent infection.

What Are the Contraindications of Vancomycin Powder?

Generally, Vancomycin powder is well tolerated. However, certain precautions or contraindications are associated with its use. The contraindications are described below:

• Hypersensitivity or Allergy: An individual who is allergic or has a known hypersensitivity should not receive the Vancomycin powder.

• Previous Adverse Reaction: A patient who has experienced severe adverse reactions to Vancomycin powder, such as anaphylaxis, should avoid this powder.

• Renal Impairment: An individual with pre-existing renal impairment is contraindicated to use Vancomycin powder. By using this powder, they may develop nephrotoxicity. Nephrotoxicity is damage to the kidney due to the harmful effects of chemicals or drugs. A close monitoring of renal function is necessary to prevent nephrotoxicity.

• Hearing Impairment: In some patients, the high dose of Vancomycin powder may cause hearing impairment. A person with pre-existing hearing impairment is at high risk of hearing loss.

• Pregnancy and Breastfeeding: The Vancomycin powder is safe during the first trimester of pregnancy. The risk of infection is higher in the second and third trimester of pregnancy and during breastfeeding.

• Pediatric Patients: A Vancomycin powder can be used in pediatric patients, but with careful consideration.

What Are the Benefits of Vancomycin Powder in High-Risk Infection?

The benefits of Vancomycin powder in high-risk infection are as follows:

• Antimicrobial Activity: The powder has antimicrobial properties. When the Vancomycin powder is applied on the surgical site, it reduces the colonization of bacteria and the risk of surgical site infections.

• Effective Against Resistant Bacterial Strains: Vancomycin powder is effective against Methicillin-resistant Staphylococcus aureus and gram-positive bacteria.

• Effective in Orthopedic Surgeries: Vancomycin powder effectively reduces postoperative infections in orthopedic surgeries.

• Prevention of Surgical Site Infections: Using Vancomycin powder at the surgical site helps prevent infections.

• Reduces Systemic Side Effects: The intravenous administration of Vancomycin powder helps in reducing systemic side effects.

What Are the Side Effects of Vancomycin Powder in High-Risk Infection?

The common side effects of Vancomycin powder in high-risk infections are as follows:

• Allergic Reaction: In some cases, applying Vancomycin powder may cause redness, irritation, and swelling at the application site. Other symptoms include rash and itching.

• Nephrotoxicity: If the Vancomycin powder is administered in high doses, it may cause renal damage.

• Ototoxicity: Using a high dose of Vancomycin powder may cause hearing loss.

• Thrombophlebitis: The intravenous administration of Vancomycin can cause inflammation of the veins.

• Muscular Pain: The neuromuscular side effects of Vancomycin powder may cause muscle pain and weakness.

• Hematologic Effects: The blood-related side effect of Vancomycin powder is reduced platelet count (thrombocytopenia).

Conclusion:

In conclusion, Vancomycin powder is associated with the prevention of post-operative infections. The powder has antibacterial and antimicrobial properties. In addition to these benefits, some side effects include allergic reactions, hearing loss, and renal impairment. The patient should discuss the benefits and risks of Vancomycin powder before applying it. The application of Vancomycin powder should be approached with caution.