True statements regarding vancomycin uses are all of the following except: September 2009
Surgical prophylaxis in MRSA prevalent areas
Drug of choice for pseudomembranous enterocolitis
Effective in penicillin-resistant pneumococcal infection
Methicillin-resistant Staphylococcus aureus infection
Ans. B: Drug of choice for pseudomembranous enterocolitis Vancomycin is used in Proven methicillin-resistant (MR) Staph. aureus (S.A.) or coagulase-negative Staphylococcal infections Serious infections where coagulase-negative Staphylococci is highly suspected (e.g., central line, prosthesis, sternotomy, etc). Endocarditis caused by methicillin-resistant Staphylococci (plus gentamicin and rifampin for prosthetic valve endocarditis caused by coagulase-negative Staphylococci). Meningitis caused by flavobacteria or Penicillin-resistant pneumococcus (plus cefotaxime) CNS shunt infection caused by methicillin resistant Staphylococci (+ rifampin) Infections caused by organisms susceptible only to vancomycin (e.g., Corynebacterium jeikium) Ampicillin-resistant enterococcal infections. Prophylaxis for major surgical procedures for implantation of prosthetic materials or devices at hospitals with a high rate of infections due to methicillin-resistant Staphylococci. A single dose administered immediately before surgery is sufficient unless the procedure lasts more than 6 hours, in which case the dose should be repeated. Prophylaxis should be discontinued after a maximum of two doses. It is second choice drug to metronidazole for antibiotic associated pseudomembranous enterocolitis caused by C.difficile.