Vancomycin

Antibiotics

Antibiotics · Glycopeptide

Vancomycin

Dose

IV 15–20 mg/kg q12h (loading 25–30 mg/kg in critically ill); PO 125 mg QDS for C. diff

Mechanism

Inhibits cell wall synthesis (binds D-Ala-D-Ala)

Indications

  • MRSA infection
  • Severe gram-positive sepsis
  • C. diff (oral)

Dose adjustment

Renal — dose by AUC or trough 15–20 mg/L for severe MRSA

Use

Slow infusion (1 g over ≥1 h) to avoid red-man syndrome.

Monitoring

Trough levels (pre-4th dose), U&E, FBC, hearing.

Side effects

  • Nephrotoxicity (additive with aminoglycosides)
  • Ototoxicity
  • Red-man syndrome (rate-related)
  • Thrombocytopenia

Related in WardRound

Always confirm dose against your local formulary / BNF before prescribing.

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