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Vancomycin + mitomycin C refers to either the combination of the glycopeptide antibiotic vancomycin and the alkylating antitumor antibiotic mitomycin C, or their covalent conjugate (VM). In preclinical research, the co-administration of vancomycin and mitomycin C has been evaluated in vitro against *Clostridioides difficile* infections, demonstrating additive but not synergistic activity. Additionally, researchers at Aarhus University have developed a vancomycin-mitomycin C conjugate (VM) linked via a disulfide bond. This conjugate acts as a targeted prodrug, where mitomycin C is selectively released at the bacterial cell surface by thiol-disulfide exchange triggered by bacterial cell surface thiols or reducing agents like N-acetylcysteine. The VM conjugate has demonstrated broad-spectrum antimicrobial activity against Gram-positive and Gram-negative bacteria, including vancomycin-resistant strains and *Staphylococcus aureus* biofilms, with reduced systemic cytotoxicity compared to free mitomycin C.
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