Indication& Dosage:
Adult:
Usual dosage range:
Initial intravenous dosing should be based on actual body weight; subsequent dosing adjusted based on serum trough vancomycin concentrations.
I.V.: 2000-3000 mg daily (or 30-60 mg/kg/day) in divided doses every 8-12 hours
Note: Dose requires adjustment in renal impairment
Oral: 500-2000 mg daily in divided doses every 6 hours
Indication-specific dosing:
C. difficile -associated diarrhea (CDAD):
Oral:Mild to moderate disease unresponsive to metronidazole: 125 mg 4 times daily for 10 days Severe, complicated infection: 500 mg every 6 hours for 10-14 days with or without concurrent I.V. metronidazole. May consider vancomycin retention enema (in patients with complete ileus)
Complicated infections in seriously-ill patients:
I.V.: Loading dose: 25-30 mg/kg (based on actual body weight) may be used to rapidly achieve target concentration; then 15-20 mg/kg/dose every 8-12 hours
Meningitis:
I.V.: 30-60 mg/kg/day in divided doses every 8-12 hours or 500-750 mg every 6 hours (with third-generation cephalosporin for PCN-resistant Streptococcus pneumoniae)
Alternate regimen: S. aureus (methicillin-resistant): 15-20 mg/kg/dose every 8-12 hours for 2 weeks (some experts combine with rifampin)
Intrathecal, intraventricular (unlabeled route): 5-20 mg/day
Pneumonia:
I.V.:Community-acquired pneumonia (CAP): S. aureus (methicillin-resistant): 45-60 mg/kg/day divided every 8-12 hours (maximum: 2000 mg/dose) for 7-21 days depending on severity Healthcare-associated pneumonia (HAP): S. aureus (methicillin-resistant): 45-60 mg/kg/day divided every 8-12 hours (maximum: 2000 mg/dose) for 7-21 days depending on severity
Susceptible (MIC ≦1 mcg/mL) gram-positive infections:
I.V.:15-20 mg/kg/dose (usual: 750-1500 mg) every 8-12 hours. Note: If MIC ≧2 mcg/mL, alternative therapies are recommended.
Pediatric:
Usual dosage range:
Infants >1 month and Children: I.V.: 10-15 mg/kg every 6 hours
Indication-specific dosing:
C. difficile -associated diarrhea (CDAD):
Infants >1 month and Children: Oral: 40 mg/kg/day in 3-4 divided doses for 7-10 days (maximum: 2000 mg/day)
Meningitis:
Infants >1 month and Children: I.V.: 15 mg/kg every 6 hours
Alternate regimen: S. aureus (methicillin-resistant): 15-20 mg/kg/dose every 8-12 hours for 2 weeks (some experts combine with rifampin)
Intrathecal, intraventricular (unlabeled route): 5-20 mg/day
Pneumonia:
Group A Streptococcus, S. aureus, moderate-to-severe infection : 40-60 mg/kg/day divided every 6-8 hours
Healthcare-associated pneumonia (HAP), S. aureus (methicillin-resistant): I.V.: Infants and Children: 60 mg/kg/day divided every 6 hours for 7-21 days depending on severity
Susceptible gram-positive infections (MIC ≦1 mcg/mL):
I.V.: Infants >1 month and Children: 10 mg/kg/dose every 6 hours or 15 mg/kg/dose (maximum: 2000 mg/dose) every 6 hours . Note: If MIC ≧2 mcg/mL, alternative therapies are recommended. |
