Antimicrobials
Vancomycin IV

Vancomycin IV

Low
N/A

Dosing

General Information

  • Aminoglycosides may potentiate nephrotoxicity
  • May enhance neuromuscular blockade of NM blocking agents
  • Careful with concomitant nephrotoxins

INFUSION RELATED (usually associated with infusion times of less than 1 hour)

  • "Red-man syndrome" characterised by hypotension, chills, fever, flushing, feeling of warmth, erythematous rash over face, neck and upper body, generalised tingling. Reaction usually resolves within 20 minutes or longer, is not an allergic reaction
  • True anaphylactic reactions, ie hypotension, wheezing, dyspnea, urticaria or pruritus are rare
  • Pain and thrombophlebitis - can be minimised by increasing dilution to 2.5 mg/mL and rotating administration sites. Irritating to tissues may cause necrosis. Consider a central line for long term therapy

MISCELLANEOUS

  • Ototoxicity
  • Nephrotoxicity
  • Cytopenias (esp. neutropenia, thrombocytopenia)

Special Considerations:

  • Oral vancomycin administration is suitable only for C. difficile infection as it is not absorbed beyond the GI tract. Do not use oral vancomycin as stepdown therapy for IV vancomycin
  • Vancomycin is a less effective choice than a beta-lactam antimicrobial for methicillin-susceptible staphylococcal infections
  • Staphylococcus aureus with an MIC of greater than or equal to 2 mg/L have a high failure rate; consider an ID consult

Antimicrobial class: Glycopeptide

Pregnancy category: C

Average serum half life: 8 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Moderate

Biliary penetration: Moderate