DRUG NAME INDICATION/CONTRAINDICATION SIDE EFFECTS/ADVERSE

EFFECT
NURSING
CONSIDERATION
GENERIC NAME:
vancomycin

BRAND NAME: Vancocin

CLASSIFICATION:
antibiotic

DOSAGE: premixed
solution 500 mg per 100 mL

FREQUENCY: q 8

ROUTE: IV injection


Serious or severe infections due to
susceptible methicillin-resistant (beta-
lactam-resistant) staphylococci in
penicillin-allergic patients; patients
who cannot receive or have failed to
respond to other drugs, including
penicillins and cephalosporins; and for
infections due to vancomycin-
susceptible organisms resistant to
other antimicrobials. Staphylococcal
endocarditis, including septicemia, and
infections of the lower respiratory
tract, bone, and skin and skin
structure. Streptococcal endocarditis
due to S. viridans or S. bovis as
monotherapy or in combination with
an aminoglycoside. Enterococcal
endocarditis due to E. faecalis in
combination with an aminoglycoside.
Diphtheroid endocarditis. Early-onset
prosthetic valve endocarditis due
to S.epidermidis or diphtheroids in
combination with rifampin, or an
aminoglycoside, or both.
Cardiovascular: Hypotension.
CNS: Headache (7%); fatigue
(5%); dizziness, vertigo (rare).
Dermatologic: Drug rash with
eosinophilia and systemic
symptoms, exfoliative
dermatitis, pruritus, rash,
Stevens-Johnson syndrome,
TEN, urticaria, vasculitis
(postmarketing).
EENT: Hearing loss; tinnitus
(rare).
GI: Nausea (17%); abdominal
pain (15%); diarrhea, vomiting
(9%); flatulence (8%);
antibiotic-associated colitis.
Genitourinary: Urinary tract
infection (8%); nephrotoxicity
including increased blood
creatinine, renal failure, and
renal impairment (5%);
increased BUN; interstitial
nephritis, renal failure (rare).
Hematologic:Reversible
agranulocytosis;eosinophilia,
reversibleneutropenia,
thrombocytopenia
(postmarketing).
Respiratory: Dyspnea,
wheezing.
Miscellaneous: Hypokalemia
Reconstituted powder
must be further diluted
prior to administration.
Concentrations of no
more than 5 mg/mL
and rates of no more
than 10 mg/min are
recommended in adults.
Administer over a
period of no less than
60 min by intermittent
infusion.
Other patient factors, such
as age or obesity, may
call for modification of
the usual IV daily dose.
The total daily IV
dosage may be lower in
neonates. In premature
infants, vancomycin Cl
decreases as
postconceptional age
decreases. Therefore,
longer dosing intervals
may be necessary in
premature infants.
Close monitoring of
serum concentrations of
vancomycin may be
warranted in these
patients.
(13%); pyrexia (9%); back pain,
peripheral edema (6%);
anaphylaxis, chills, drug fever,
hypotension, red man syndrome
(flushing of the face, neck,
upper chest, and extremities)
(postmarketing).

Certain parenteral
products may be
administered orally.
Dilute in 1 oz of water.
Common flavoring
syrups may be added to
the solution. The
diluted solution may be
given via nasogastric
tube.
Thaw frozen Galaxy
containers at room
temperature or under
refrigeration. Do not
thaw by water bath
immersion or by
microwave.
Monitor hearing, blood,
renal function. Monitor
vancomycin serum
concentrations closely.
Elderly. Debilitated.
Pregnancy (Cat.C).
Nursing mothers: not
recommended.