Vancomycin IV

C. diff Risk

None

Oral Bioavailability

NA

Approximate Cost

$ 5.78/day

Dosing

See Vancomycin Nomogram in "Guidelines" Section

General Information

Common Usage

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

Drug Monitoring

Vancomycin peak levels do not correlate with efficacy and are of no value to guide dosage adjustment. Peak levels are no longer performed at Eastern Health.

Vancomycin trough level and serum creatinine (Pharmacy consult recommended)

CBC at least weekly for duration of therapy > 7 days

Adverse Effects

  •  Nephrotoxicity

  •  Cytopenias (should have weekly CBC if therapy > 7 days)

  •  Rash including Stevens-Johnson Syndrome

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

Major Interactions

Aminoglycosides may potentiate nephrotoxicity.

Careful with concomitant nephrotoxins.

Additional Information

IV Administration
Compatible with D5W or NS.

Maximum concentration for peripheral administration: 5 mg/mL

Infusion time:
1000 mg or less = 60 min
1001-1500 mg (90 min)
1501-2000 mg (2 hrs)

EH Prescribing Restrictions
None (Pharmacist reviews therapy)

Community IV Formulary (Metro Area)
YES

Pharmacy may adjust dose if consulted (Write request on med order sheet).

For complete vancomycin dosing and monitoring policy see Intranet:
PHA-161 : Intravenous Vancomycin Therapy Management by Clinical Pharmacist
(Adult Acute Care and Community IV Antibiotic Program)]

Pharmacology

Antimicrobial class: Glycopeptide

Pregnancy category: C

Average serum half life: 8 hours (may be > 200h in ESRD)

Biliary penetration: Moderate

CSF penetration: Moderate

Lung penetration: Therapeutic

Urine penetration: Therapeutic