Usual starting dose: Infants and children: 60 mg/kg/DAY IV divided q6-8h; usual maximum starting dose 4 g/DAY. Dose should then be adjusted based on serum drug level monitoring.
Renally cleared, requires dosage adjustment with changes in renal function. Consult a pharmacist for renal dosing.
Suspected or proven MRSA, coagulase-negative Staphylococcal infections, Enterococcal infections
When to check serum levels: Check pre-level 0-1 hours before 3rd-4th (neonates) or 5th-6th (infants/children) dose, with dosage changes, and weekly for courses more than 10
Target serum levels: 15 to 20 mg/L for CNS infections and MRSA infections. 10 to 20 mg/L for all other infections and empiric therapy.
Monitor serum creatinine and urine output throughout therapy.
Red man syndrome (histamine release- slow down infusion), nephrotoxicity, cytopenias.
Aminoglycosides may potentiate nephrotoxicity
Use caution and increase monitoring of renal function when used with concomitant nephrotoxins.
Antimicrobial class: glycopeptide
Average serum half life: Newborns: 6 to 10 hours.
Infants and Children 3 months to 4 years: 4 hours.
Children and Adolescents >3 years: 2.2 to 3 hours
Route of Elimination: Primarily via glomerular filtration; excreted as unchanged drug in the urine (80% to 90%)