Spectrum: Local Antimicrobial Stewardship, for Billings Clinic

Vancomycin PO

C. diff Risk

NA

Oral Bioavailability

None

Approximate Cost

See Below

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

Dosing

Adult

125mg po q6h

Severe complicated disease (toxic megacolon) in combination with IV metronidazole: 500 mg po q6h

Intra-colonic dose
500 mg rectal enema q6h

General Information

Common Usage

Common Usage

Only indication is in the therapy of C. difficile infection

Cost Dollar

Cost

Suspension

  • $6/day

Outpatient

  • Sometimes cheaper capsules depending on insurance but note prices are increasing

  • Many pharmacies charge for full suspension bottle, inpatient suspension is cheaper

Caps

  • $12/day

  • Nonformulary and not stocked inpatient

Drug Monitoring

Drug Monitoring

Limited role with limited absorption in most cases. Absorption may be seen with severe toxic megacolon/leaking gut with high doses of PO/PR vancomycin.

Additional Information

Additional Information

Limited oral absorption.

Pharmacology

Pharmacology

Antimicrobial class: Glycopeptide

Pregnancy category: B

Biliary penetration: None

CSF penetration: None

Lung penetration: None

Urine penetration: None