Spectrum: Local Antimicrobial Stewardship, for Island Health

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

See "Vancomycin IV Dosing Nomogram" under Syndromes

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 Troughs
Most Serious Infections
15-20 mg/L
For example:

  •  MRSA

  •  Endocarditis

  •  Deep-seated infections

  •  Osteomyelitis

Possibly higher targets (20-25mcg/mL) for meningitis

Less Severe Infections
10-15 mg/L

Consult clinical pharmacy for dosing.

Adverse Effects

Adverse Effects

  •  Nephrotoxicity

  •  Cytopenias

  •  Rash including Stevens-Johnson Syndrome

  •  Red man syndrome (histamine release- slow down infusion to avoid)

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

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Moderate

Biliary penetration: Moderate