Antibacterial activities and modes of action of vancomycin and related glycopeptides

Vancomycin (21) is produced by Amycolatopsis orientalis (18) (previously designated Nocardia orientalis and Streptomyces orientalis). The antibiotic has been marketed for the past 30 years and continues to be marketed, as the hydrochloride salt, to treat deep-seated gram-positive bacterial infections. It is the drug of choice for infections caused by Staphylococcus aureus, especially those caused by strains resistant to methicillin. Vancomycin is bactericidal to most gram-positive organisms, but gram-negative organisms are resistant. Vancomycin is not absorbed from the gastrointestinal tract, and the antibiotic is used to treat enterocolitis, especially that caused by Clostridium difficile