Vancomycin Peak

CPT Code

80202

Specimen Type

Blood

Container Type

Red-Clot Activator

Stability

2-8°C, 7 days

Handling Instructions

Allow to clot for 30 minutes; centrifuge within 2 hours; transfer to pour off tube

Clinical Notes

Vancomycin hydrochloride is a tricyclic glycopeptide derived from Amycolatopsis orientalis. It is commonly used in the treatment of methicillin-resistant Staphylococcus aureus infections. This glycopeptide inhibits the growth of the bacterium by intervening in the cell wall synthesis, thereby killing the bacterium. The peak therapeutic range for vancomycin is between 20 to 40 μg/mL and the trough is 5 to 10 μg/mL. Side effects of vancomycin are deafness (ototoxicity) and renal failure (nephrotoxicity) at levels above therapeutic range. Extensive review articles have been published which fully examine vancomycin’s effectiveness and pharmacokinetics.Vancomycin is absorbed minimally from the gastrointestinal tract. In the first 24 hours after intravenous dosing, the usual route of administration, about 90% of the vancomycin is excreted unchanged by the kidneys. The average half-life in patients with normal renal function is about 6 hours. Vancomycin is approximately 55% bound to plasma proteins. Therapeutic serum levels vary depending on the microorganism involved and the patient’s tolerance to the drug. Vancomycin serum or plasma concentrations are monitored to guide therapy, since individual patient differences require dose changes that are difficult to predict. Monitoring serum or plasma levels of vancomycin decreases the frequency of serious toxic effects.