Spectrum: Local Antimicrobial Stewardship, for AHS Calgary Zone

Vancomycin IV

C. diff Risk

None

Oral Bioavailability

NA

Approximate Cost

$40/day

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

General Spectrum of Activity

Antibiogram Data

Dosing

Adult

25-30mg/kg IV loading dose rounded to nearest 250mg (max of 2g per dose); 15mg/kg IV q8-12h maintenance depending on trough goal

Renal

General Information

Common Usage

Common Usage

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

Drug Monitoring

Drug Monitoring

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

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

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

If trough >20, increase dosing interval or decrease dose

Adverse Effects

Adverse Effects

Red man syndrome (histamine release- slow down infusion), nephrotoxicity, cytopenias, rash including Stevens-Johnson Syndrome, others

Major Interactions

Major Interactions

Aminoglycosides may potentiate nephrotoxicity

May enhance neuromuscular blockade of NM blocking agents

Careful with concomitant nephrotoxins

Pharmacology

Pharmacology

Antimicrobial class: glycopeptide

Pregnancy category: C

Average serum half life: 8.0

Biliary penetration: Moderate

CSF penetration: Moderate

Lung penetration: Therapeutic

Urine penetration: Therapeutic