Vancomycin

Other Anti-infective Preps · Glycopeptide

Indications

Overwhelming staphylococcal infections where the organisms are resistant to other antibiotics.

Dosage

IV: Adults: 500 mg every 6 hr or 1 gm every 12 hr. Children: 10 mg/kg every 6 hr. Infants & Neonates: 15 mg/kg 1 dose then 10 mg/kg every 12 hr for 1st wk of life, & every 8 hr up to 1 mth of age.

Administration

IV: Administer vancomycin by IV intermittent infusion over at least 60 min at a final conc not to exceed 5 mg/ mL. Administration of antihistamines just before the infusion may also prevent or minimize Red man syndrome. Compatibility: Stable in dextran 6% in NS, D5W, D5% NS, RL, D5% RL, NS, D10W. Y-site administration: Drug to Drug IV Compatibility: Acyclovir, amikacin, amiodarone, bumetanide, calcium gluconate, cimetidine, cisatracurium, diltiazem, diphenhydramine, dobutamine, dopamine, enalapril, epinephrine, esmolol, famotidine, fentanyl, fluconazole, gentamicin, hydromorphone, imipenem, insulin regular, labetalol, levofloxacin, linezolid, lorazepam, magnesium sulphate, meropenem, methylprednisolone, metoclopramide, midazolam, milrinone, morphine, nitroglycerin, nitroprusside, norepinephrine, ondansetron, phenylephrine, ranitidine, tobramycin, vasopressin, vecuronium. Drug to Drug IV…

Adverse Effects

Infusion related events (anaphylactoid reactions, flushing), nephrotoxicity, ototoxicity, neutropenia, nausea, chills, fever, rashes, eosinophilia, phlebitis, decreased BP, dyspnoea, stridor, pruritus, mucosal inflammation, eosinophilia, phlebitis, severe pain at inj site, Stevens-Johnson syndrome, toxic epidermal necrolysis, bullous dermatosis (discontinue).

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Lactation: Contraindicated or not recommended. Precautions: Impaired renal function. Previous hearing loss. Elderly. Monitor blood levels, hepatic, renal and auditory function, blood counts and urine parameters. Inflammatory bowel disease.

Interactions

Neurotoxic, ototoxic or nephrotoxic drugs, anaesthetics, PPIs, antimotility agents.

Advice to Patient

Take with meals. Use a calibrated measuring device to accurately measure doses of oral solution. Complete full course of therapy even if you feel better. Contact prescriber if there is redness/burning/pain/chills at infusion site or if there is skin rash, difficulty in breathing, hives, fever, sore throat, burning, itching on urination, vaginal discharge, white patches in mouth, decreased urine output, chest pain, palpitations, changes in hearing, feeling of fullness in ears, severe persistent diarrhoea or worsening of condition or if there is no improvement in few days. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Keep follow-up appointments during and after treatment.

Pharmacokinetics

Note: Displays time-dependent antimicrobial killing; slowly bactericidal. Absorption: Oral: Poor; Rectal: Significant absorption through inflamed colonic mucosa may occur; Intraperitoneal (IP): 60% of an IP dose absorbed in 6 hrs. Metabolism: No apparent metabolism. Half-life elimination: Biphasic: Terminal: Newborns: 6-10 hrs. Neonates receiving ECMO: 6.53 ± 2.1 hrs; others have reported longer: 10.4 ± 6.7 hrs. Infants and Children 3 mths-4 yrs: 4 hrs. Children and Adolescents >3 yrs: 2.2-3 hrs. Adults: 4-6 hrs, significantly prolonged with renal impairment. End-stage renal disease (ESRD): 7.5 days. Time to peak, serum: IV: Immediately after completion of infusion. Excretion: Primarily via glomerular filtration; IV: Urine (75% as unchanged drug in the first 24 hrs); Oral: Primarily faeces.

Brands with this active ingredient

Compiled by Healify Pharmacy from published drug references. How we compile it →

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