{"id":4892,"date":"2020-02-22T05:29:19","date_gmt":"2020-02-21T19:29:19","guid":{"rendered":"https:\/\/doseme-rx.com\/?p=4892"},"modified":"2021-04-13T16:51:44","modified_gmt":"2021-04-13T06:51:44","slug":"infusion-guidelines","status":"publish","type":"post","link":"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/infusion-guidelines","title":{"rendered":"Vancomycin infusion guidelines"},"content":{"rendered":"\n<p><a href=\"https:\/\/doseme-rx.com\/vancomycin-dosing\">Vancomycin<\/a>&nbsp;is a&nbsp;glycopeptide&nbsp;antibiotic&nbsp;used to treat serious, life-threatening infections. It has been used in clinical practice for over 60 years and is one of the most commonly used antibiotics in hospitals today. <\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Vancomycin&nbsp;modes of administration: Oral vs Intravenous<\/strong><\/h3>\n\n\n\n<p>When&nbsp;vancomycin&nbsp;is given orally as a capsule or liquid that\ncan be swallowed, its use is limited to treating two specific gastrointestinal infections:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Diarrhea associated with&nbsp;<em>Clostridium difficile&nbsp;<\/em><\/li><li>Enterocolitis due to&nbsp;<em>Staphylococcus aureus<\/em>&nbsp;(including&nbsp;MRSA)<\/li><\/ul>\n\n\n\n<p>Vancomycin&nbsp;is poorly absorbed when taken orally, so it cannot help\nwith infections in other parts of the body. <\/p>\n\n\n\n<p>Intravenous vancomycin is commonly used for the treatment of resistant gram positive organisms such as methicillin resistant Staphylococcus aureus (MRSA), methicillin-resistant Staphylococcus epidermidis (MRSE) and select infections caused by Enterococci. It is commonly used for the treatment of these severe infections :<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Heart valve infections (endocarditis)<\/li><li>Bone infections (osteomyelitis)<\/li><li>Blood infections (bacteremia)<\/li><li>Certain types of pneumonia<\/li><li>Serious skin infections<\/li><li>Meningitis<\/li><\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Vancomycin <strong>infusion related&nbsp;reactions<\/strong><\/h3>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"740\" height=\"380\" src=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2016\/12\/Image_News-Article_03.jpg\" alt=\"\" class=\"wp-image-457\" srcset=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2016\/12\/Image_News-Article_03.jpg 740w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2016\/12\/Image_News-Article_03-300x154.jpg 300w\" sizes=\"(max-width: 740px) 100vw, 740px\" \/><\/figure>\n\n\n\n<p>A possible <a href=\"https:\/\/doseme-rx.com\/news\/20200808-vancomycin-side-effects\">side effect<\/a> that may occur if&nbsp;vancomycin&nbsp;is infused too rapidly includes an allergic reaction (anaphylactoid reaction) known as \u00ab\u00a0red man syndrome\u00a0\u00bb. This is the most common allergic reaction in younger patients (under age 40) who received intravenous&nbsp;vancomycin.&nbsp;Red man syndrome&nbsp;consists of an itchy, hot, red rash that affects the upper body, face, and neck. It may occasionally spread to the extremities. It&rsquo;s characterized by swelling under the skin, weakness, dizziness, a rapid heartbeat, fever, chills, chest pain, or back pain.&nbsp;<\/p>\n\n\n\n<p>Other adverse reactions that may occur with a rapid infusion\nof&nbsp;vancomycin&nbsp;include:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Hypotension (a sudden drop in blood pressure)<\/li><li>Wheezing<\/li><li>Shortness of breath<\/li><li>Itching (pruritus)<\/li><li>Hives<\/li><li>Inflammation of a vein (phlebitis)<\/li><li>Flushing of the upper body (\u00ab\u00a0red neck syndrome\u00a0\u00bb)<\/li><li>Chest pain or muscle spasm<\/li><li>Neck pain or muscle spasm<\/li><\/ul>\n\n\n\n<p>Infusion-related reactions are related to both the concentration of&nbsp;vancomycin&nbsp;and the rate of infusion. To minimize&nbsp;these adverse reactions,&nbsp;vancomycin&nbsp;should be diluted before it is administered as per the product insert, and infused slowly over a period of at least one hour, or at an&nbsp;infusion&nbsp;rate&nbsp;of 10mg\/min or less. <\/p>\n\n\n\n<p>In general, most reactions that occur due to rapid infusion will resolve within 20 minutes, but they can occasionally persist for several hours. Supportive care may be provided for&nbsp;red man syndrome, which is a histamine reaction.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Vancomycin<strong> non-infusion related reactions<\/strong><\/h3>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"740\" height=\"380\" src=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/12\/ID-Week-Poster-Blog-740x380-1.png\" alt=\"AUC24 vancomycin Bayesian-based dosing: Increasing therapeutic target attainment with decreased TDM cost\" class=\"wp-image-4678\" srcset=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/12\/ID-Week-Poster-Blog-740x380-1.png 740w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/12\/ID-Week-Poster-Blog-740x380-1-300x154.png 300w\" sizes=\"(max-width: 740px) 100vw, 740px\" \/><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Ototoxicity<\/strong><\/h4>\n\n\n\n<p>Hearing loss&nbsp;(ototoxicity) is a side effect that may occur after receiving intravenous&nbsp;vancomycin. It is more common in patients who were exposed to high levels of&nbsp;vancomycin&nbsp;over long periods of time. It has been discovered mostly in patients who had pre-existing hearing problems, those who were given a higher&nbsp;vancomycin&nbsp;dose, or were using&nbsp;vancomycin&nbsp;with other medications that can also damage hearing (such as&nbsp;aminoglycoside&nbsp;antibiotics).<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Acute Kidney Injury<\/strong><\/h4>\n\n\n\n<p>Acute kidney injury (AKI) is another possible side effect of&nbsp;vancomycin&nbsp;infusion.&nbsp;Certain patients are at high risk of developing AKI, including those who are obese, have pre-existing kidney problems (renal impairment), and the critically ill. In patients receiving&nbsp;vancomycin, a greater&nbsp;risk of&nbsp;nephrotoxicity&nbsp;occurs when doses exceed 4 grams per day and&nbsp;<a href=\"https:\/\/doseme-rx.com\/news\/20191119-vancomycin-trough-level-recommendations\">trough levels<\/a>&nbsp;are higher than 15mcg\/mL and an AUC above 600 mg-h\/L is present.<\/p>\n\n\n\n<p>Vancomycin&nbsp;associated AKI can be measured in different ways, but a\ncommon definition of AKI is either:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li>An increase in&nbsp;serum creatinine&nbsp;of &gt;0.5 mg\/dL or a 50% increase from      baseline in consecutive daily readings, or<\/li><li>A decrease in calculated&nbsp;creatinine clearance&nbsp;of 50% from baseline on two consecutive days in the absence of an alternative explanation. <\/li><li>Newer studies suggest that a more sensitive threshold of an increase in&nbsp;serum creatinine&nbsp;&gt;0.3 mg\/dL over a 48-hour period may be an indicator of AKI.<\/li><\/ol>\n\n\n\n<p>AKI can be potentiated in patients that are receiving other medications\nthat also require the kidney for elimination. It is important to monitor kidney\nfunction in patients receiving&nbsp;vancomycin&nbsp;who are also receiving\nother medications that can damage the kidneys, such as antimicrobials (e.g.\namphotericin B,&nbsp;aminoglycosides, polymyxins, or piperacillin\/tazobactam),\nloop diuretics, or certain types of chemotherapy such as&nbsp;cisplatin. <\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Vancomycin dosing<\/strong><\/h3>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"1024\" height=\"526\" src=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/04\/Complex-criticallyillBlog-01-1024x526.png\" alt=\"Vancomycin dosing in critically-ill patients\" class=\"wp-image-4002\" srcset=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/04\/Complex-criticallyillBlog-01-1024x526.png 1024w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/04\/Complex-criticallyillBlog-01-300x154.png 300w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/04\/Complex-criticallyillBlog-01-768x394.png 768w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p>Historically, vancomycin may be dosed on a milligram\/kg basis or a\nstandard dose (e.g. 1000mg) , adjusted for renal function. Monitoring of serum\nvancomycin trough levels has been used to predict efficacy. For mild to\nmoderate infections, a trough level of 10-15mg\/L is usually targeted. For more\nsevere infections, the goal is to achieve a trough level of between 15-20mg\/L. <\/p>\n\n\n\n<p>Some&nbsp;vancomycin&nbsp;nomograms&nbsp;have been developed to help\npatients achieve&nbsp;the higher vancomycin&nbsp;trough concentrations&nbsp;of\n15 to 20mg\/L. These nomograms&nbsp;are charts where clinicians can use a\npatient&rsquo;s&nbsp;creatinine clearance&nbsp;and&nbsp;actual&nbsp;body\nweight&nbsp;to determine an appropriate&nbsp;starting and\/or maintenance dose.\nUnfortunately, few studies have evaluated the safety and efficacy of using\nsuch&nbsp;nomograms&nbsp;to guide&nbsp;vancomycin&nbsp;therapy. One report\nfound that using a&nbsp;nomogram&nbsp;did not reduce the incidence of AKI and\nsignificantly fewer patients met target&nbsp;trough levels.<\/p>\n\n\n\n<p>The new 2019 draft of the <a href=\"https:\/\/doseme-rx.com\/news\/20190601-vancomycin-dosing-therapeutic-guideline-2019\">revised&nbsp;vancomycin&nbsp;therapeutic guidelines<\/a> recommends a move away from monitoring&nbsp;vancomycin&nbsp;trough levels&nbsp;and towards a metric that measures total drug exposure in relation to the organism\u2019s minimum inhibitory concentration. This is referred to as an <a href=\"https:\/\/doseme-rx.com\/vancomycin-literature-review\">AUC24:MIC<\/a> (24-hour area under the curve (AUC) to minimum&nbsp;inhibitory concentration&nbsp;ratio). Dosing&nbsp;vancomycin&nbsp;using trough-only monitoring will no longer be recommended. The previously mentioned&nbsp;nomograms&nbsp;would not be helpful when these new guidelines become the standard of care.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Continuous drug infusion vs intermittent drug infusion<\/strong><\/h3>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"740\" height=\"380\" src=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2018\/08\/vanc-loading-dose-740px-1-e1538978883523.jpg\" alt=\"vancomycin loading dose DoseMeRx blog\" class=\"wp-image-2669\" srcset=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2018\/08\/vanc-loading-dose-740px-1-e1538978883523.jpg 740w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2018\/08\/vanc-loading-dose-740px-1-e1538978883523-300x154.jpg 300w\" sizes=\"(max-width: 740px) 100vw, 740px\" \/><\/figure>\n\n\n\n<p>The 2019 draft of the revised&nbsp;vancomycin&nbsp;therapeutic guidelines has recommended that patients maintain a&nbsp;steady-state vancomycin concentration of 20-25 mg\/L during the entire dosing period. Using a&nbsp;continuous infusion&nbsp;is a fast and convenient way to reach this target drug concentration. It makes monitoring serum levels faster and easier since&nbsp;dose adjustments&nbsp;can be made instantly by changing the rate of infusion. Simply multiply the&nbsp;steady-state&nbsp;concentration by 24 to determine the AUC24 (Area under the concentration curve over 24 hours).<\/p>\n\n\n\n<p>The risk of kidney damage or nephrotoxicity seems to be equal or lower with&nbsp;continuous infusion&nbsp;(as opposed to&nbsp;intermittent infusion). The major disadvantage to&nbsp;continuous infusion&nbsp;in critically&nbsp;ill patients&nbsp;is that&nbsp;vancomycin&nbsp;is not compatible with many commonly co-administered drugs, so separate IV lines or catheters must be placed specifically for&nbsp;vancomycin.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Related Articles<\/h3>\n\n\n\n<p>If you enjoyed this article, here&rsquo;s some other vancomycin content for you:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><a href=\"https:\/\/doseme-rx.com\/news\/20200330-vancomycin-dosing-guidelines-what-to-know\">Official Vancomycin Dosing Guidelines<\/a><\/li><li><a href=\"https:\/\/doseme-rx.com\/vancomycin-dosing-calculator\">Vancomycin Trough and Dosing Calculator<\/a><\/li><li><a href=\"https:\/\/doseme-rx.com\/news\/20191119-vancomycin-trough-level-recommendations\">A Guide to Vancomycin Trough Levels<\/a><\/li><li><a href=\"https:\/\/doseme-rx.com\/news\/20181219-vancomycin-dosing-pediatrics\">Vancomycin Pediatric Dosing<\/a><\/li><\/ul>\n\n\n\n<p><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Try DoseMeRx For Free<\/h3>\n\n\n\n<p>We support vancomycin dosing AUC calculations with a wide range of vancomycin models using&nbsp;<a href=\"https:\/\/doseme-rx.com\/vancomycin-dosing\">DoseMeRx \u2013 a bayesian dosing calculator<\/a>. Try the DoseMeRx<a href=\"https:\/\/doseme-rx.com\/vancomycin-dosing-calculator\">&nbsp;free online AUC dosing calculator&nbsp;<\/a>or evaluate the full DoseMeRx platform free for 14-days.&nbsp;<a href=\"https:\/\/doseme-rx.com\/start-trial\">Start trial now \u2192<\/a><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">References<\/h3>\n\n\n\n<p><em><a href=\"https:\/\/medlineplus.gov\/druginfo\/meds\/a601167.html\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"MedlinePlus Drug Information.&nbsp;Vancomycin&nbsp;Injection. Available online at https:\/\/medlineplus.gov\/druginfo\/meds\/a601167.html. Accessed February 4, 2020. (opens in a new tab)\">MedlinePlus Drug Information.&nbsp;Vancomycin&nbsp;Injection. Available online at https:\/\/medlineplus.gov\/druginfo\/meds\/a601167.html. Accessed February 4, 2020.<\/a><\/em><\/p>\n\n\n\n<p><em><a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2018\/208910s000lbl.pdf\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"CutisPharma. Firvanq (vancomycin) [package insert]. U.S. Food and Drug Administration website. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2018\/208910s000lbl.pdf. Revised January 2018. Accessed February 4, 2020. (opens in a new tab)\">CutisPharma. Firvanq (vancomycin) [package insert]. U.S. Food and Drug Administration website. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2018\/208910s000lbl.pdf. Revised January 2018. Accessed February 4, 2020.<\/a><\/em><\/p>\n\n\n\n<p><em><a href=\"https:\/\/www.ashp.org\/-\/media\/assets\/policy-guidelines\/docs\/draft-guidelines\/draft-guidelines-ASHP-IDSA-PIDS-SIDP-therapeutic-vancomycin.ashx\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Rybak MJ, Le J, Lodise TP, Levine DP, Bradley JS, Liu C, Mueller BA, Pai MP, Wong-Beringer A, Rotschafer JC, Rodvold KA, Maples HD, Lomaestro B; et al. \u201cTherapeutic Monitoring of&nbsp;Vancomycin: A Revised Consensus Guideline.\u201d. Am J Health Syst Pharm 2009; 66(1): 82-98. Accessed February 4, 2020. (opens in a new tab)\">Rybak MJ, Le J, Lodise TP, Levine DP, Bradley JS, Liu C, Mueller BA, Pai MP, Wong-Beringer A, Rotschafer JC, Rodvold KA, Maples HD, Lomaestro B; et al. \u201cTherapeutic Monitoring of&nbsp;Vancomycin: A Revised Consensus Guideline.\u201d. Am J Health Syst Pharm 2009; 66(1): 82-98. Accessed February 4, 2020.<\/a><\/em><\/p>\n\n\n\n<p><em><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=a078d9c2-f89c-4f9f-8ded-60ffb2983c3f\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"ANI Pharmaceuticals. Vancocin (vancomycin) [package insert]. U.S. Food and Drug Administration website. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/060180s047lbl.pdf. Revised January 2017. Accessed February 4, 2020. (opens in a new tab)\">ANI Pharmaceuticals. Vancocin (vancomycin) [package insert]. U.S. Food and Drug Administration website. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/060180s047lbl.pdf. Revised January 2017. Accessed February 4, 2020.<\/a><\/em><\/p>\n\n\n\n<p><em><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK482506\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Martel TJ, Jamil RT, King KC.&nbsp;Red Man Syndrome. [Updated 2019 Jun 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. &nbsp;Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK482506\/&nbsp; (opens in a new tab)\">Martel TJ, Jamil RT, King KC.&nbsp;Red Man Syndrome. [Updated 2019 Jun 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. &nbsp;Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK482506\/&nbsp;<\/a><\/em><\/p>\n\n\n\n<p><em><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5057197\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"O'Brien KA, Mok S. Evaluation of the Safety of a&nbsp;Vancomycin&nbsp;Nomogram&nbsp;Used to Achieve Target&nbsp;Trough Concentrations. Hosp Pharm. 2015;50(10):900\u2013910. doi:10.1310\/hpj5010-900&nbsp; (opens in a new tab)\">O&rsquo;Brien KA, Mok S. Evaluation of the Safety of a&nbsp;Vancomycin&nbsp;Nomogram&nbsp;Used to Achieve Target&nbsp;Trough Concentrations. Hosp Pharm. 2015;50(10):900\u2013910. doi:10.1310\/hpj5010-900&nbsp;<\/a><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Vancomycin&nbsp;is a&nbsp;glycopeptide&nbsp;antibiotic&nbsp;used to treat serious, life-threatening infections. It has been used in clinical practice for over 60 years and is one of the most commonly used antibiotics in hospitals today. Vancomycin&nbsp;modes of administration: Oral vs Intravenous When&nbsp;vancomycin&nbsp;is given orally as a capsule or liquid that can be swallowed, its use is limited to treating two [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":7655,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[26],"tags":[28,27,37],"article-type":[49],"class_list":["post-4892","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-vancomycin","tag-auc","tag-trough","tag-vancomycin-dosing"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Vancomycin infusion guidelines - DoseMeRx<\/title>\n<meta name=\"description\" content=\"Revised vancomycin therapeutic guidelines recommend a move away from monitoring vancomycin trough levels and towards AUC\/MIC total drug exposure.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/infusion-guidelines\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Vancomycin infusion guidelines - 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