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Vancomycin

Medical and Pharmacy Editor:

Brand Name: N/A

Generic Name: Vancomycin

Drug Class: Glycopeptides

What Is Vancomycin and How Does It Work?

Vancomycin is a prescription drug used to treat a certain intestinal condition (colitis) that may rarely happen after treatment with antibiotics. This condition causes diarrhea and stomach/abdominal pain. When vancomycin is taken by mouth, it stays in the intestines to stop the growth of bacteria that cause these symptoms.

This antibiotic treats only bacterial infection in the intestines. It will not work for bacterial infections in any other part of the body or for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.

Dosage of Vancomycin:

Adult and pediatric dosages:

Capsule

  • 125 mg
  • 250 mg

Injectable solution

  • 5 mg/solution

Powder for injection

  • 500 mg
  • 750 mg
  • 1 g
  • 5 g
  • 10 g

Dosage Considerations – Should be Given as Follows:

Pseudomembranous Colitis/Staphylococcal Enterocolitis

  • C. difficile: 125 mg orally every 6 hours for 10 days
  • S. enterocolitis: 0.5-2 g/day orally divided every 6-8 hours for 7-10 days
  • Because of cost of capsules, intravenous solution is sometimes compounded for oral use

Endocarditis

Adults

  • Treatment: 500 mg intravenously every 6 hours or 1 g intravenously every 12 hours
  • Used for staphylococcal, streptococcal, and diphtheroid endocarditis; current American Heart Association (AHA) guidelines recommend using only for high-risk patients

    Pediatric

  • Children older than 1 month: 15 mg/kg followed by 10 mg/kg intravenously every 12 hours for neonates in first week of life and every 8 hours thereafter up to 1 month of age; longer dosing intervals recommended in premature infants
  • Infants under 1 month: 10 mg/kg/day intravenously divided every 6 hours; individual dose not to exceed 1 g
  • Current American Heart Association guidelines recommend using only for high-risk patients

Preoperative Antimicrobial Prophylaxis (Off-label)

Adult

  • Gastrointestinal (GI) and genitourinary (GU) procedures: 1 g intravenously by slow infusion over 1 hour, beginning 1-2 hours before procedure (with or without gentamicin 1.5 mg/kg; not to exceed 120 mg intravenously or intramuscularly less than 30 minutes before procedure)

Pediatric

  • Gastrointestinal (GI) and genitourinary (GU) procedures: 20 mg/kg intravenously by slow infusion over 1 hour, beginning 1 hour before procedure (with or without gentamicin 1.5 mg/kg; not to exceed 120 mg intravenously or intramuscular less than 30 minutes before procedure)

Surgical Prophylaxis (Off-label)

  • Prophylaxis of infection in cardiac, thoracic, and arterial procedures; craniotomy; joint replacement; amputation
  • 15 mg/kg intravenously over 1-2 hours; begin administration within 2 hours before incision; duration of prophylaxis for most procedures should be less than 24 hours

Bacterial Meningitis (Pediatric)

  • 15-20 mg/kg intravenously every 6 hours

Pseudomembranous Colitis (Pediatric)

  • 40 mg/kg/day orally divided every 608 hours for 7-10 days, not to exceed 2 g/day

Other Infections (Pediatric)

  • 40 mg/kg/day intravenously divided every 6 hours

Dosing Modifications

  • Renal impairment: 15 mg/kg initially; further doses are based on renal function, serum drug level, and institutional protocol; dosing intervals range from every 24 hours to every 96 hours, depending on severity of impairment

Dosing Considerations

    Adults

    • General dosing recommendation: 2 g/day intravenously divided every 6-12 hours; may be increased on basis of body weight or to achieve higher trough values; increased toxicity at dosage over 4 g/day
    • Peak values 18-26 mg/L; trough values 5-10 mg/L; however, Infectious Diseases Society of America and other guidelines urge troughs 15-20 mg/L

    Pediatric

    • Neonatal dosing
      • Infant less than 7 days and under 1.2 kg: 15 mg/kg intravenously once daily; monitor serum levels and adjust dose
      • Infant less than 7 days and 1.2-2 kg: 10-15 mg/kg intravenously every 12-18 hour; monitor serum levels and adjust dose
      • Infant less than 7 days and over 2.1 kg: 10-15 mg/kg intravenously every 8-12 hours; monitor serum levels and adjust dose
      • Infants older than 7 days and less than 1.2 kg: 15 mg/kg intravenously every 24 hours; monitor serum levels and adjust dose
      • Infants older than 7 days and 1.2-2 kg: 10-15 mg/kg intravenously every 8-12 hours; monitor serum levels and adjust dose
      • Infants older than 7 days and over 2.1 kg: 15-20 mg/kg intravenously every 8 hours; monitor serum levels and adjust dose
Medically Reviewed by a Doctor on 6/8/2017



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