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
