Vancomycin IV

C. diff Risk

None

Oral Bioavailability

NA

Approximate Cost

$40/day

Dosing

Adult

See "Vancomycin IV Dosing Nomogram" under Syndromes

General Information

Common Usage

Suspected or proven MRSA, coagulase-negative Staphylococcal infections, Enterococcal infections

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

  •  Nephrotoxicity

  •  Cytopenias

  •  Rash including Stevens-Johnson Syndrome

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

Major Interactions

Aminoglycosides may potentiate nephrotoxicity.

May enhance neuromuscular blockade of NM blocking agents.

Careful with concomitant nephrotoxins.

Pharmacology

Antimicrobial class: glycopeptide

Pregnancy category: C

Average serum half life: 8.0

Biliary penetration: Moderate

CSF penetration: Moderate

Lung penetration: Therapeutic

Urine penetration: Therapeutic