A B C D E F G H I J K L M N O P Q R S T U V W X Y Z # |
Vancomycin, Random, Plasma or Serum
Test CodeVANCOR - NOCO
CPT Codes
80202
Preferred Specimen
1 mL plasma from Green top (Lithium Heparin)
Minimum Volume
0.5 mL
For neonate requirements see Neonate Minimum Blood Volumes
For neonate requirements see Neonate Minimum Blood Volumes
Other Acceptable Specimens
1 ml serum from Serum Gel or Red Top
Instructions
- Indicate exact time drug was started, exact time infusion was completed in label comments (i.e. IV 1200 /1230). If the drug will be administered by intramuscular injection, indicate time of injection in label comments (i.e. IM 1300).
Specimen Stability
Specimen Type | Temperature | Time |
Plasma Li Hep | Refrigerated | 2 days |
Serum SST | Refrigerated | 2 days |
Red Top – Separated* | Refrigerated | 2 days |
*Centrifuge and aliquot into a plastic vial.
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis
Methodology
Bichromatic Turbidimetric Rate - Particle Enhanced Turbidimetric Inhibition Immunassay (PETENIA)
Setup Schedule
Monday through Sunday; Continuously
Report Available
Same day
Reference Range
<60 µg/mL
Critical value (automatic call-back): >60.0 µg/mL
Critical value (automatic call-back): >60.0 µg/mL
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.
Performing Laboratory
Banner Fort Collins Medical Center Laboratory
McKee Medical Center Laboratory
North Colorado Medical Center Laboratory