Vancomycin monitoring


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1.   Monitoring parameters:

Vancomycin trough level

Obtain at steady-state (approximately four half lives) and then weekly during therapy.

BUN and serum creatinine

Measure every two days, or every day in unstable renal function.


Weigh patient every two to seven days.

Urine output

Measure and monitor urine output daily.

Baseline and weekly audiograms.
Check for signs of phlebitis daily.


2.   Therapeutic serum concentrations (mcg/ml)

Although considerable controversy exists, the following target serum levels are currently recommended:

Routine peak level monitoring is no longer recommended
Trough level
For serious infections, such as bacteremia, infective endocarditis, osteomyelitis, meningitis, pneumonia, and severe SSTI (eg, necrotizing fasciitis) due to MRSA, vancomycin trough concentrations of 15–20 mcg/ml are recommended.
For less serious infections such as skin and soft tissue infections, trough concentrations of 10-20 mcg/ml are recommended.


See also:



Pharmacokinetic formulas



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