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Vancomycin

Manufactured by Fresenius
Sourced in Denmark, Germany

Vancomycin is a laboratory product used for the detection and quantification of the antibiotic vancomycin. It is a glycopeptide antibiotic commonly used to treat infections caused by Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA). The product is designed to facilitate the monitoring of vancomycin levels in patient samples, which is important for ensuring appropriate dosing and therapeutic management.

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7 protocols using vancomycin

1

Vancomycin and Rifampin Combination Therapy

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Prior to surgery, mice were randomized to one of two treatment groups or a control group (n = 10 per group). Mice in the vancomycin group were subcutaneously administered a therapeutic dose of vancomycin (110 mg/kg twice daily) (Mylan, Cannonsburg, PA), which approximated the area under the curve (AUC) of 440 μg⋅h/ml for typical human exposure for vancomycin (1g twice daily).[29 (link)–31 (link)] Mice in the combination therapy group were administered a therapeutic subcutaneous mouse dose of rifampin (25 mg/kg daily) (Fresenius Kabi, Lake Zurich, IL) in addition to vancomycin therapy (110 mg/kg twice daily).[32 (link)] This rifampin dose was chosen based on previously published studies of various mouse models of staphylococcal infection.[32 (link)–36 (link)] All antibiotic therapy and sham injections of sterile saline were initiated on postoperative day 7 and continued through postoperative day 14 to mimic the treatment of an established SII. The MICs for Xen36 were ≤0.5 μg/ml for vancomycin and ≤0.5 μg/ml for rifampin.
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2

Vancomycin Exposure Routes in Mice

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After two weeks of acclimatization in group specific cages, female BALB/cJ mice were exposed either to oral (O) or intranasal (IN) vancomycin or intranasal PBS (PBS). The O group (n=7) was given 200 mg/L vancomycin (Fresenius Kabi, Denmark) ad libitum in drinking water from a dark water bottle ad libitum for 14 days [30 (link)]. The vancomycin-water was changed every two days. The IN (n=8) and PBS (n=6) groups were anesthetised by isoflurane and dosed with 35 µL for 2×5 days with two days in between covering both nares by intra nasal instillation (i.n.). The IN groups were dosed with 0.12 mg vancomycin and the PBS group with pyrogen free saline (0.9%) (Fresenius Kabi, Denmark). Two days after the last exposure, the animals were killed and BAL, NAL and caecum samples were collected. Data represent a single experiment.
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3

Antibiotic Cocktail for Gut Microbiome Depletion

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At the end of the day 0 meal test, participants ingested an antibiotic ‘cocktail’ containing 500 mg meropenem (powder for infusion; Farmaplus, Oslo, Norway), 500 mg vancomycin (powder for infusion; Fresenius Kabi, Bad Homburg, Germany) and 40 mg gentamicin (solution for injection; Sandoz, Basel, Switzerland) dissolved in 150 ml of apple juice. The ‘cocktail’ was a modified version of previous protocols used for prophylactic treatment of intensive care unit patients [20 (link),21 (link)]. It was designed to eradicate as many gut bacteria as possible with the lowest possible risk of side effects. None of the 3 types of antibiotics are absorbed by the healthy mucosa, and therefore have no direct effects on metabolism [22 (link)–24 (link)]. On day 1, 2 and 3, participants ingested the same antibiotic ‘cocktail’ at the same time of the day.
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4

Antibiotic Decontamination of Tissue Samples

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Following dissection and morphology evaluation, tissue is decontaminated in an antibiotic solution at + 4 °C for 24–48 h. The antibiotic solution contains Vancomycin (50 μg/ml, Fresenius Kabi, Germany), Lincomycin (120 μg/ml, Pfizer, USA) and Polymyxin B (100 μg/ml, Caelo, Germany) in sterile Medium 199 (M199, Lonza, Switzerland). The decontamination solution does not contain antifungal agent like amphotericin B. This decision was made based on previous observations about its potential cytotoxic effect (Gall et al. 1995 (link), 1998 (link)) and some reported cases of its ineffective fungal decontamination (Kuehnert et al. 1998 (link)). Therefore, CTB’s list of contaminants that should result in tissue discard if detected at any stage of processing includes all fungi.
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5

Antimicrobial Efficacy Evaluation in Mice

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Dicloxacillin (Diclocil, Bristol-Myers Squibb) and Vancomycin (Vancomycin, Fresenius Kabi, Denmark) were purchased and used as the commercial product registered in Denmark for parenteral clinical use. Thioridazine (Thioridazine hydrochloride, Sigma-Aldrich Corporation, Denmark) was purchased and used in its racemic form.
Dosages were set on behalf of the given references in Table 1 and considerations on clinical applicability in humans. However, VAN was intentionally and according to the study by Docobo-Perez et al. [15 (link)] set at a high dose compared to the equivalent dose in humans. The rationale was to make sure that Vancomycin had been administered in adequate dosages in order to be a useful positive control, and to minimize the risk of a type II error when comparing other treatments to Vancomycin.
According to the equivalent daily dosages in mice (Table 1), the antimicrobial agents were dissolved in isotonic saline (Amgros I/S, Denmark) at concentrations fitted for an injection of 0.5 ml twice a day. Mice treated with the combination treatment (DCX +TDZ) had two injections at different sites to avoid the possibility of crystallization or altered absorption when the drugs were mixed. Hence, this group of mice had a total volume of 1 ml twice a day. TDZ was at all times before injection protected from sunlight due to its decomposing effect on the drug.
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6

Antibacterial Nanomaterial Evaluation

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The following antibacterial substances were used: vancomycin (Fresenius, Kabi, Bad Homburg, Germany), Al2O3 nanowires (diameter × L 2–6 nm × 200–400 nm Sigma-Aldrich in powder form), and TiO2 nanoparticles (Nanografi, Turkey).
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7

Pharmacokinetic Analysis of Vancomycin, Folic Acid, and Iohexol

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Rats were administered clinical-grade vancomycin (lot number 167973; Fresenius Kabi, Lake Zurich, IL, USA), folic acid (lot number WXBD4723V; Sigma-Aldrich, St. Louis, MO, USA), iohexol (Omnipaque) (lot number 15025174; GE Healthcare, Inc., Marlborough, MA, USA), and normal saline for injection (Hospira, Lake Forest, IL, USA). vancomycin was prepared by weighing and dissolving the powder in normal saline to achieve a final concentration of 100 mg/mL. folic acid was prepared by weighing and dissolving the powder in 0.3 mM sodium bicarbonate to achieve a final concentration of 50 mg/mL. Analytical-grade iohexol (lot number LRAC5648; Sigma-Aldrich, St. Louis, MO, USA) and iohexol-d 5 (lot number 28540; Cayman Chemical, Ann Arbor, MI, USA) were used for liquid chromatography-tandem mass spectrometry (LCMS) analyses of plasma samples.
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