Antimicrobials
Vancomycin IV

Vancomycin IV

Low
N/A
IV: $7.28/Dose; $72.80/5 Days

Dosing

General Information

  • For treatment of serious infections caused by beta-lactam resistant gram-positive microorganisms (i.e. MRSA).

  • For treatment of infections caused by susceptible gram-positive microorganisms in patients who have serious allergies to first line beta-lactam antimicrobials.

Monitor renal function (serum creatinine and BUN) at baseline and minimum once weekly if stable.

Monitor trough levels (drawn ~1/2 hr prior to dose):

  • Assuming normal renal function, initial trough level usually drawn ~pre-4th dose (TBRHSC pharmacist will advise on further dosing/monitoring). Trough levels can be drawn more frequently if deemed clinically appropriate and/or with impaired renal function.
  • For hemodialysis: Usually draw initial vancomycin level pre-hemodialysis with 3rd dose.
  • Recommended Intermittent IV Vancomycin Steady State Trough Targets for Adults:
    • All CNS infections (i.e. meningitis, discitis, epidural abscess, CNS shunt infections): 15-20 mg/L
    • MRSA (confirmed or suspected), non-CNS infections: 15 +/- 2 mg/L
    • Other non-MRSA and non-CNS infections: 10-13 mg/L
    • Dialysis (Hemodialysis, Peritoneal dialysis, CRRT): 15-20 mg/L
  • Note: If the minimum inhibitory concentration (MIC) of Staphylococcus aureus is greater than 1 mg/L, consider alternative therapy to vancomycin to decrease risk of treatment failure.

Other Monitoring Parameters:

  • CBC
  • Nephrotoxicity
  • Cytopenias (Neutropenia)
  • Rash including DRESS
  • Vancomycin infusion reaction (histamine release- slow down infusion)
  • Aminoglycosides may potentiate nephrotoxicity.
  • May enhance neuromuscular blockade of NM blocking agents.
  • Careful with concomitant nephrotoxins.

Antimicrobial class: Glycopeptide

Pregnancy category: C

Average serum half life: 4-6 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Moderate

Biliary penetration: Moderate