Vancomycin

General

• Type: Glycopeptides
• Dosage Forms:
  • IV
  • PO: Mix IV form with 30mL water
  • PR: Mix IV form with 100mL NS
• Common Trade Names: Vancocin

Adult Dosing

General

• <50kg: 500mg IV q12h
• 50-69kg: 750mg IV q12h
• >70kg: 1000mg IV q12h
• Alternative (All Weights): 10-15 mg/kg IV q12
• Adjust dose based on serum levels

C. Difficile Infection

• 1st occurrence
  • Uncomplicated: 125mg PO q6h x 10-14 days
  • Complicated: 500mg PO/NG q6h
    • May use in combo with metronidazole IV
    • Consider adding vancomycin 500mg PR q6 if complete ileus
• 2nd occurrence
  • Uncomplicated: 125mg PO q6h x 10-14 days
  • Complicated: 500mg PO/NG q6h
    • May use in combo with metronidazole IV
    • Consider adding vancomycin 500mg PR q6 if complete ileus
• 3rd+ occurrence
  • 125mg PO q6h x 10-14 days, then daily x 7 days, then q2-3 days x 2-8 wk

Staphylococcal Enterocolitis

• 500-2000 mg/day PO divided q6-8h x 7-10 days
• First Dose: 500mg PO x 1

Special Populations

• Pregnancy: C
• Lactation: Probably safe
• Renal Dosing
  • Adult
    • CrCl 50-90: 15mg/kg x1, then usual dose q12-24h
    • CrCl 10-50: 15mg/kg x1, then usual dose q24h-96h
    • CrCl <10: 15mg/kg x1, then usual dose q4-7 days
    • Hemodialysis: Give supplement only if high-flux dialyzer used
    • Peritoneal dialysis: No supplement
  • Pediatric
    • CrCl 10-50: give q18-48h
    • CrCl <10: give q48-96h
    • Hemodialysis: Give supplement only if high-flux dialyzer used
    • Peritoneal dialysis: No supplement
• Hepatic Dosing (Adult & Pediatric)
  • Not defined

Contraindications

• Allergy to class/drug

Pharmacology

• Half-life:
• Metabolism:
• Excretion:
• Mechanism of Action:

See Also

• Antibiotics (Main)

Source

• Epocrates