Vancomycin: Difference between revisions
Line 71: | Line 71: | ||
*Info: Repeat dosing may require up to 1200-1500mg IV q12h or 10 mg/kg IV q8 | *Info: Repeat dosing may require up to 1200-1500mg IV q12h or 10 mg/kg IV q8 | ||
===[[ | ===[[Clostridium Difficile]]=== | ||
*40 mg/kg/day PO divided q6-8h x 7-10 days | *40 mg/kg/day PO divided q6-8h x 7-10 days | ||
*First Dose: 10-13 mg/kg x 1 | *First Dose: 10-13 mg/kg x 1 |
Revision as of 04:43, 3 March 2014
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
All: Adjust repeat doses based on serum levels
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
Pediatric Dosing
All: Adjust repeat doses based on serum levels
General (<7 Days Old)
- <1.2kg
- 15 mg/kg IV q24h
- First Dose: 15 mg/kg IV x 1
- 1.2-2kg
- 10-15 mg/kg IV q12-18h
- First Dose: 10-15 mg/kg IV x 1
- >2.1kg
- 10-15 mg/kg IV q8-12h
- First Dose: 10-15 mg/kg IV x 1
General (7 Days - 1 Month Old)
- <1.2kg
- 15 mg/kg IV q24h
- First Dose: 15 mg/kg IV x 1
- 1.2-2kg
- 10-15 mg/kg IV q8-12h
- First Dose: 10-15 mg/kg IV x 1
- >2.1kg
- 15-20 mg/kg IV q8
- First Dose: 15-20 mg/kg IV x 1
General (1 Month - 11 Years)
- 10-15 mg/kg IV q6-8h
- First Dose: 10-15 mg/kg IV x 1
- Max: 1 gram per dose
General (12 - 16 Years)
- 1000 mg IV q12h
- First Dose: 1000mg IV x 1
- Alt: 10-15 mg/kg IV q12
- Info: Repeat dosing may require up to 1200-1500mg IV q12h or 10 mg/kg IV q8
Clostridium Difficile
- 40 mg/kg/day PO divided q6-8h x 7-10 days
- First Dose: 10-13 mg/kg x 1
- Max 500mg/dose, 2000mg/day
- For severe infection or recurrence
- May use in combination with metronidazole PO
Staphylococcal Enterocolitis
- 40 mg/kg/day PO divided q6-8h x 7-10 days
- First Dose: 10-13 mg/kg x 1
- Max 500mg/dose, 2000mg/day
Community-Acquired Pneumonia
- 40 mg/kg/day PO divided q6-8h x 10-14 days
- First Dose: 10-13 mg/kg x 1
- Info: Switch to appropriate oral regiment when possible
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
- Adult
- Hepatic Dosing (Adult & Pediatric)
- Not defined
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
Common
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
- Mechanism of Action:
See Also
Source
- Epocrates