Suspected or proven MRSA, coagulase-negative Staphylococcal infections, Enterococcal infections.
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
Cytopenias (should have weekly CBC if therapy > 7 days)
Rash including Stevens-Johnson Syndrome
Red man syndrome (histamine release- slow down infusion)
Aminoglycosides may potentiate nephrotoxicity.
Careful with concomitant nephrotoxins.
Compatible with D5W or NS.
Maximum concentration for peripheral administration: 5 mg/mL
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)
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)]
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