Suspected or proven MRSA, coagulase-negative Staphylococcal infections, Enterococcal infections
Pregnancy: Compatible.
Breastfeeding: Compatible.
Order vancomycin troughs only if the patient meets the following criteria:
OR
Measure trough level at steady state before 4th dose for most patients, but if abnormal/fluctuating renal function then measure before 3rd dose.
Target trough 10-15 mg/L.
See Vancomycin Nomogram under Syndromes for dosing information.
Monitor trough weekly to ensure within therapeutic range.
Monitor creatinine at least twice weekly.
Vancomycin flushing syndrome (histamine release- slow down infusion rate), nephrotoxicity, cytopenias, rash including Stevens-Johnson Syndrome
Aminoglycosides may potentiate nephrotoxicity
May enhance neuromuscular blockade of NM blocking agents
Additive nephrotoxicity with concomitant nephrotoxins
Antimicrobial class: Glycopeptide
Average serum half life: 8.0
Biliary penetration: Moderate
CSF penetration: Moderate
Lung penetration: Therapeutic
Urine penetration: Therapeutic