Lymphadenitis, bacterial
Vancomycin IV

Vancomycin IV



General Information

Suspected or proven MRSA, coagulase-negative Staphylococcal infections, Enterococcal infections.

Collect trough 0-1h before 3rd dose if abnormal/fluctuating renal function.

Target trough 15-20 mcg/mL for most serious infections, 20-25 mcg/mL for meningitis

If trough low, increase dose (do not exceed 2 g/dose) OR decrease dosing interval.

If trough >20, increase dosing interval or decrease dose.


  • Hypokalemia
  • Abdominal pain
  • Diarrhea
  • Nausea
  • Vomiting


  • Cardiac arrest
  • Hypotension
  • Clostridium difficile diarrhea
  • Agranulocytosis
  • Neutropenia
  • Thrombocytopenia
  • Anaphylaxis
  • Drug reaction with eosinophilia and systemic symptoms
  • Ototoxicity
  • Nephrotoxicity
  • Piperacillin
  • Tobramycin
  • Gentamicin
  • Amikacin
  • Cholera vaccine, live
  • 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: 8 hours

Biliary penetration: Moderate

CSF penetration: Moderate

Lung penetration: Therapeutic

Urine penetration: Therapeutic


  • Caution in patients with renal insufficiency due to increased risk for nephrotoxicity and ototoxicity with IV administration.
  • Discontinue use at the first appearance of signs and symptoms of dermatologic reaction.
  • Monitoring recommended with oral therapy and dose adjustments recommended with IV administration in elderly patients.
  • Infusion-related reactions, including hypotension and cardiac arrest, may occur; administer in dilute solution over at least 60 minutes and stop infusion if reaction occurs.