Vancomycin hydrochloride is primarily used as an antibiotic to treat severe bacterial infections, particularly those caused by Gram-positive bacteria. It is often administered for infections that are resistant to other antibiotics, such as methicillin-resistant Staphylococcus aureus (MRSA). It is also effective in treating infections like endocarditis, meningitis, osteomyelitis, and septicemia.

In clinical settings, it is commonly given intravenously for systemic infections or orally for treating Clostridioides difficile-associated colitis, as it is poorly absorbed through the gastrointestinal tract. Its use is typically reserved for serious cases due to the risk of antibiotic resistance and potential side effects, such as kidney damage or hearing loss.

Vancomycin hydrochloride is also utilized in prophylactic measures for patients undergoing certain surgeries or those at high risk of developing infections, such as individuals with compromised immune systems. Its role in combating life-threatening infections makes it a critical component in modern medicine.