Vancomycin: Difference between revisions
From IDWiki
No edit summary |
No edit summary |
||
| Line 35: | Line 35: | ||
* Can decrease dose or prolong infusion, prophylactic antihistamines |
* Can decrease dose or prolong infusion, prophylactic antihistamines |
||
[[Category: |
[[Category:Glycopeptides]] |
||
Revision as of 20:10, 31 January 2020
Indications
- Suspected or confirmed MRSA
Dosing
- Common dose
- 15mg/kg/dose with timing based on renal function (q12h if normal)
- Titrate based on serum trough drawn within hour before fourth dose
- Target trough
- 10-15 for low-risk infections
- 15-20 for high-risk infections such as osteomyelitis, meningitis, and bacteremia
Adverse Reactions
Renal Failures
- Risk factors
- Prolonged courses >21 days
- Higher trough
- Concomitant nephrotoxic medication
- Older age
- CKD/AKI
- Liver disease
- Peritonitis
- Neutropenia
- Male sex
- Mechanism of injury: oxidative stress in the proximal tubular cells
Red Man Syndrome
- Rash, pruritis, and hypotension, with onset of vancomycin, resolves on stopping
- Very high incidence previously
- Histamine-mediated
- Can decrease dose or prolong infusion, prophylactic antihistamines
References
- ^ Michael J Rybak, Jennifer Le, Thomas P Lodise, Donald P Levine, John S Bradley, Catherine Liu, Bruce A Mueller, Manjunath P Pai, Annie Wong-Beringer, John C Rotschafer, Keith A Rodvold, Holly D Maples, Benjamin M Lomaestro. Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: A revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists. American Journal of Health-System Pharmacy. 2020. doi:10.1093/ajhp/zxaa036.
