Clinical use
Therapeutic drug monitoring. When patients are being treated with antibiotics such as this, it is important that levels are monitored to ensure that they are not so high that they are toxic or so low that they are ineffectual.
Background
Intravenous vancomycin requires therapeutic drug monitoring (TDM). Vancomycin has a narrow “therapeutic index” – the difference between the toxic and therapeutic doses of medications. For some drugs, maintaining this steady concentration in the blood cannot be achieved by simply giving a standard dose of medication to everyone. TDM aims to optimise individual dosage regimens, enabling the assessment of safety and efficacy of certain drugs. Current TDM approaches include measuring drug serum concentration together with appropriate medical interpretation.
Reference range
Expected levels (mg/L) Pre dose 10-15 but 15-20 in complicated infections OR Steady state during continuous infusion 15-25.
Patient preparation
None required
Specimen requirements
- Adult: Gold top serum separator
- Paediatric: clotted blood
Please supply details of:
- The time and date of the sample
- the time date of the last dose
- Number of days of therapy
Minimum volume
- Adult: 5ml
- Paediatric: 1ml
Turnaround time
<1 day from receipt at the reference laboratory
Analysing laboratory
Biochemistry Laboratory, James Cook University Hospital, Marton Road, TS4 3BW
Additional information
For guidance on dose adjustment as per levels, please discuss with Microbiology or the Antimicrobial Pharmacy team.