How is this possible, you might ask? All other antibiotics out there totally wipe out our gut flora, increase our intestinal permeability, and give us many related side-effects. But the thing about vancomycin is that it is too big a molecule to pass through the gut-blood barrier. So if you take vanco via IV, the drug will not get into the guts and kill your lovely gut flora. Likewise, if you take vanco orally, all it will do is kill your gut flora and not benefit any other part of your body (that's why CFers don't use oral vanco unless we're trying to kill a gut infection, like C. difficile).
Fascinating, huh? So why is this useful info? Well, this latest time I went into the hospital, I had the docs give me only one thing: IV vanco. My main bug is MRSA, and although I grow pseudomonas, it doesn't really give me any symptoms. MRSA is what causes me the most problems (increased cough, mucus, fever, etc.) so I decided to experiment with using only IV vanco this time. And it was fantastic! Comparing this hospitalization to all of my previous ones, where I've always been treated with one MRSA drug (vanco or linezolid) and two pseudo drugs (usually meropenum and ceftazadime - my body doesn't like Tobi), I had almost no side effects (besides the initial stage of Red Man's syndrome, which I prevent by infusing the doses at very slow rates for the first 3 days). No gut problems, no diarrhea, and none of the weird, random side-effects that I get from linezolid (which, by the way, I am convinced are a result of increased intestinal permeability caused by the drug). Instead of the initial 4-5 days in the hospital being miserably sick from the drugs themselves, I started to feel better within a day or two after starting the vanco alone. Without all the drug-induced side-effects of the pseudo drugs, I could actually feel the positive impacts that the vanco was having on my infection within a couple of days. That's never happened before. I was very proud of myself for discovering this secret. I can treat my lung infection and at the same time protect my gut flora! Success!
That said, I did have some kidney issues because I tried to leave the hospital with home IV vanco before we had gotten the dose right, so I had to come back in and finish the course in the hospital. But next time I am going to make sure we get the dose absolutely right before I leave with the home IVs. My goal is to have this be my regular every-3-4 month "clean-out" routine, with most of it happening at home. Anyway, thought I'd share this with the community, since very few people people (not even my docs) know this secret about vanco.