Last reviewed 2026-04-22 · How we verify

Vancomycin CI

Vancomycin inhibits bacterial cell wall synthesis by binding to D-Ala-D-Ala peptidoglycan precursors, preventing cross-linking and causing cell wall rupture.

Vancomycin inhibits bacterial cell wall synthesis by binding to D-Ala-D-Ala peptidoglycan precursors, preventing cross-linking and causing cell wall rupture. Used for Serious or life-threatening infections caused by susceptible strains of methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile-associated diarrhea and colitis, Endocarditis caused by susceptible strains of streptococci or staphylococci.

At a glance

Mechanism of action

Vancomycin is a glycopeptide antibiotic that binds to the D-alanyl-D-alanine terminus of peptidoglycan precursors in bacterial cell walls, blocking transglycosylation and transpeptidation reactions essential for cell wall integrity. This leads to cell wall weakening and bacterial cell lysis. It is bactericidal and particularly effective against gram-positive organisms.

Approved indications

• Serious or life-threatening infections caused by susceptible strains of methicillin-resistant Staphylococcus aureus (MRSA)
• Clostridium difficile-associated diarrhea and colitis
• Endocarditis caused by susceptible strains of streptococci or staphylococci
• Septicemia caused by susceptible gram-positive organisms

Common side effects

• Nephrotoxicity
• Ototoxicity
• Red man syndrome (flushing, erythema)
• Phlebitis at infusion site
• Fever
• Chills

Key clinical trials

• Combination Study of Antibiotics With Enzalutamide (PROMIZE) (PHASE1, PHASE2)
• Safety and Outcomes Associated With Continuous Versus Intermittent Infusion Vancomycin (PHASE4)

Primary sources

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