The proper dose of IV vancomycin should be administered slowly over at least 60 minutes at a rate of 10 mg/minute to prevent adverse infusion reactions.
The updated approach now takes into account age, sex, body weight and serum creatinine (Scr). Recent pharmacokinetic studies have provided an equation for estimating daily maintenance dosing of vancomycin in obese patients. Every person will process vancomycin at a different rate and dosing can be tailored to an individual patient. This also helps to determine when the next dose should be administered to the patient. Vancomycin has a narrow therapeutic window, and it is easy to underdose or overdose a patient.īlood work is done to ensure vancomycin trough levels remain within this window to prevent organ damage or antibiotic resistance. In order for vancomycin to work correctly, a certain concentration needs to be maintained in the blood. If the adult patient is obese, loading doses of 20-25mg/kg using actual body weight, up to 3000mg may be considered.įor obese pediatric patients, the recommended dose is 20mg/kg based on total body weight. In non-obese adults with normal kidney function, they recommend a loading dose of 20-35mg/kg/day, with a maximum dose of 3000mg given in a single dose.įor non-obese children and neonates, a loading dose is not recommended. Vancomycin is processed in the kidneys, and too much drug given at once can be damaging. In all cases, further dosing should be guided by blood concentrations.įor seriously ill patients, the guidelines suggest consideration of a loading dose which by definition is a one-time large dose that is given to a patient who is starting with no vancomycin in their blood. Patients who are considered obese may require higher doses. In elderly patients and/or those with impaired kidney function, the dose of vancomycin is reduced. In non-obese children with normal renal function who are 3 months to less than 12 years, the recommended dose is 60-80mg/kg/day given in divided doses given every 6 hours.įor non-obese children who are 12 years and above, the recommended dose is 60-70mg/kg/day, given in divided doses every 6 to 8 hours. They recommend that non-obese adults with normal kidney function receive a starting dose of 15 to 20mg/kg IV (based on actual body weight) given every 8 to 12 hours. New vancomycin dosing guidelines for the treatment of serious MRSA infections were published in 2020 by several leading pharmacy and infectious disease groups. It is important to note that vancomycin and other antibiotics are not effective in treating viral infections. Vancomycin is also useful for treating infections in patients allergic to penicillin or cephalosporins. Bacterial infections in the eye (bacterial endophthalmitis).Prevention of Group B streptococcal infections in newborns.
Necrotizing skin and soft tissue infections.Vancomycin is often used to treat other conditions off-label, such as: Infection of the inner lining and valves of the heart (endocarditis).Intravenous vancomycin can also be used for a variety of other serious or severe infections, including: MRSA and MRSE are both resistant to beta-lactam antibiotics (for example, oxacillin), which are commonly used to treat most staph infections. methicillin-resistant Staphylococcus epidermis (MRSE).methicillin-resistant Staphylococcus aureus (MRSA).The Food and Drug Administration (FDA) has approved IV-administered vancomycin to treat bacterial infections, from: However, the drug has poor oral bioavailability and is broken down in the stomach and intestines before it can enter the bloodstream to treat systemic infections.Īs a result, for systemic infections, vancomycin is given intravenously (IV) for better efficacy.
Oral vancomycin is given to treat Clostridiodes ( Clostridium) difficile infections and infection-induced diarrhea.