A Short History of Vancomycin

Vancomycin was first isolated by E.C. Kornfeld (working at Eli Lilly) from a soil sample collected from the interior jungles of Borneo by a missionary. The organism that produced it was eventually named Streptomyces orientalis. The original indication for vancomycin was for the treatment of penicillin-resistant Staphylococcus aureus.

The compound was initially labelled compound 05865, but was eventually given the generic name, vancomycin derived from the word "vanquished". One advantage that was quickly apparent was that staphylococci did not develop significant resistance despite serial passage in culture media containing vancomycin. The rapid development of penicillin-resistance by staphylococci led to the compound being fast-tracked for approval by the FDA in 1958. Eli Lilly first marketed vancomycin hydrochloride under the trade name Vancocin.

Vancomycin never became first line treatment for Staphylococcus aureus for several reasons:

1.) The drug must be given intravenously, because it is not absorbed orally. 2.) β-lactamase-resistant semi-synthetic penicillins such as methicillin (and its successors, nafcillin and cloxacillin) were subsequently developed. 3.) Early trials using early impure forms of vancomycin ("Mississippi mud") which were found to be toxic to the ears and to the kidneys; these findings led to vancomycin being relegated to the position of a drug of last resort.

In 2004, Eli Lilly licensed Vancocin to ViroPharma in the U.S., Flynn Pharma in the UK and Aspen Pharmacare in Australia. The patent expired in the early 1980s and generic versions of the drug are also available under various trade names.