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Vancomycin

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Introduction

This is a restricted antibiotic and requires approval for use from the Infectious Disease team. It is used for:

  • Treatment of serious gram positive infections
  • Serious infections due to methicillin-resistant staphylococcus aureus (MRSA).

Dose 

  • 15mg/kg IV every six hours
  • Usual maximum daily dose - 2grams.  Higher doses may be used in certain cases.  Please consult ID team or pharmacy for further advice on dosing
  • For dosing in neonates refer to Newborn guidelines
  • Doses must be reduced in patients with renal dysfunction.
  • Administer via peripheral or central line       

Monitoring 

  • Trough levels only- take trough immediately before the next dose.   

  • Approximate time to reach steady state is 1-2 days, check trough initially after 3-5 doses then every 3 to 5 days if satisfactory level and normal renal function

  • Aim for trough: 10mg-15mg/L, up to 20mg/L in certain cases.

  • Monitor serum electrolytes and creatinine (check for renal toxicity) 

Further Reading/Associated Documents

Newborn Guidelines on Vancomycin

Lab Plus Handbook

Paediatric IV Administration Guidelines - ADHB only

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Document Control

  • Date last published: 01 October 2013
  • Document type: Clinical Guideline
  • Services responsible: Paediatric Infectious Diseases
  • Author(s): Emma Best
  • Editor: Greg Williams
  • Review frequency: 2 years

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