Vancomax Dosage/Direction for Use

Vancomycin is given as the hydrochloride but doses are expressed in terms of the base. It is administered intravenously, preferably by intermittent infusion, although continuous infusion has been used. For intermittent infusion, a concentrated solution containing the equivalent of 500 mg of vancomycin in 10 mL of water is prepared and then added to glucose 5% or sodium chloride 0.9% to produce a diluted solution containing not more than 5 mg per mL; this diluted solution is then infused over at least 60 minutes for 500-mg dose or 100 minutes for 1-g dose. Final concentration of up to 10 mg per mL may be used for patients requiring fluid restriction, although there is an increased risk of adverse events. For continuous intravenous infusion the equivalent of 1 to 2 g is added to a sufficiently large volume of glucose or sodium chloride to permit the daily dose to be given over a period of 24 hours.
The usual adult dose is the equivalent of 500 mg of vancomycin every 6 hours or 1 g every 12 hours. Response is generally seen within 48 to 72 hours in sensitive infections. In patients with staphylococcal endocarditis, treatment for at least 3 weeks has been recommended.
For the prophylaxis of endocarditis in high-risk penicillin-allergic patients undergoing dental or other procedures, vancomycin may be given before the procedure in a single dose of 1 g by intravenous infusion over at least 100 minutes followed by intravenous gentamicin. Or as prescribed by the physician.
Doses in infants and children: Children and infants over 4 weeks of age may be given 10 mg per kg bodyweight every 6 hours. Neonates and infants up to 4 weeks old may be given an initial dose of 15 mg per kg; this is followed by 10 mg per kg every 12 hours in the first week of life or by 10 mg per kg every 7 hours in those aged 1 to 4 weeks. For the prophylaxis of endocarditis in children a single dose mg per kg may be used. Or as prescribed by the physician.
Direction for Reconstitution: For intermittent infusion, a concentrated solution containing the equivalent of 500 mg of vancomycin in 10 mL of water is prepared and then added to glucose 5% or sodium chloride 0.9% to produce a diluted solution containing not more than 5 mg per mL; this diluted solution is then infused over at least 60 minutes for 500-mg dose or 100 minutes for 1-g dose. Final concentration of up to 10 mg per mL may be used for patients requiring fluid restriction, although there is an increased risk of adverse events. For continuous intravenous infusion the equivalent of 1 to 2 g is added to a sufficiently large volume of glucose or sodium chloride to permit the daily dose to be given over a period of 24 hours.