Indications for adding Vancomycin

Positive blood culture for gram-positive bacteria, before final identification and susceptibility testing is available

Suspected catheter-related infection (chills, rigors with infusion through catheter and cellulitis around the catheter entry/exit site)

Skin or soft tissue infection

Hemodynamic instability or other evidence of severe sepsis

Severe pneumonia, as documented by hypoxia or extensive infiltrates

Colonization with MRSA or penicillin-resistant Streptococcus pneumonia

Severe mucositis, especially if FQ prophylaxis has been given and/or ceftazidime monotherapy is employed empirically (these patients are at increased risk of bacteremia due to viridians streptococci)