Vancomycin: An overview on current alternative antibiotic therapy to vanquish

Objectives: For more than 60 years, vancomycin has continued to be in clinical use despite drug resistance. Therefore, finding alternative antibiotics to vancomycin is of great need and urgency. The main objective was to provide robust evidence for the clinical pros and cons of these alternatives. Methods: A rigorous literature search was conducted for studies involving vancomycin and suitable alternatives such as teicoplanin, linezolid, tedizolid, dalbavancin, telavancin, daptomycin, tigecycline, quinupristin/dalfopristin (streptogramins) and ceftobiprole/ceftaroline (cephalosporins). Key findings: This review explored the limitations associated with the clinical utility of vancomycin in day-to-day clinical practice. New remedies such as ceftaroline, ceftobiprole, tedizolid, dalbavancin and oritavancin with specific clinical utility are becoming available and offer enhanced tolerability profile, effective cure rate and minimum rates of resistance. However, these alternatives are not without limitations. Conclusions: We objectively provide suitable alternatives to vancomycin that could be included in hospital formularies and guidelines. However, caution must be undertaken when utilizing these alternatives, given their limitations.