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Vancomycin, Trough
MessagePerformed in Chemistry
Test Code
VANCOT
CPT Codes
80202
Preferred Specimen
Green Top LiHep, Plasma
Other Acceptable Specimens
Gold/SST or Red Top
Instructions
Draw just before next dose.
Specimen Stability
Room Temperature 48 hours
Refrigerated 14 days
Frozen 12 months
Refrigerated 14 days
Frozen 12 months
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Collected in outdated/expired tube
Hemolyzed, icteric or lipemic
Contaminated
Hemolyzed, icteric or lipemic
Contaminated
FDA Status
FDA Approved
Setup Schedule
Daily, Sunday through Saturday
Report Available
Less than 4 hours
Clinical Significance
Vancomycin is a complex glycopeptide antibiotic, which is used for the treatment of infections caused by Gram‑positive organisms, primarily methicillin resistant Staphylococcus aureus (MRSA), coagulase‑negative Staphylococci, Streptococci or Enterococci, particularly in patients allergic to β‑lactams.
Common side effects include, amongst others, the following: (a) red man syndrome, a histamine‑mediated flushing during or immediately following infusion, (b) nephrotoxicity, and (c) ototoxicity; the latter two adverse events are dose/level dependent.
In former years the monitoring of peak and trough levels has been recommended. Meanwhile the relevance of monitoring peak concentrations is questioned by some clinicians due to limited clinical data. Monitoring of trough serum or plasma levels is necessary to ascertain clinical efficacy and to limit potentially dose‑dependent serious side effects, e.g. ototoxicity and nephrotoxicity. The potential for the latter two serious adverse events has established therapeutic drug monitoring (TDM) of vancomycin as the standard of care. Trough levels are typically obtained before or after the 4th dose of the drug and then monitored at least once weekly.
Common side effects include, amongst others, the following: (a) red man syndrome, a histamine‑mediated flushing during or immediately following infusion, (b) nephrotoxicity, and (c) ototoxicity; the latter two adverse events are dose/level dependent.
In former years the monitoring of peak and trough levels has been recommended. Meanwhile the relevance of monitoring peak concentrations is questioned by some clinicians due to limited clinical data. Monitoring of trough serum or plasma levels is necessary to ascertain clinical efficacy and to limit potentially dose‑dependent serious side effects, e.g. ototoxicity and nephrotoxicity. The potential for the latter two serious adverse events has established therapeutic drug monitoring (TDM) of vancomycin as the standard of care. Trough levels are typically obtained before or after the 4th dose of the drug and then monitored at least once weekly.
