Vancomycin assays: Target range and result interpretation.

• The target range for the "Pre-dose" is 10-15 mg/L in most cases.
• Below 10 mg/L is sub-therapeutic. 
• Potential toxicity may be seen if pre-dose levels are >20 mg/L.
• F
• Normal pre-dose level:
  • Repeat the assay in 3 days (so long as renal function remains unchanged).
• Low pre-dose level 
  • Sub-therapeutic 
  • The dose or frequency should be increased.
• High pre-dose level
  • Potentially toxic
  • Reduce the overall dosing regimen after discussion with microbiology.

   

• After any dose adjustment, repeat the vancomycin assay just before the 3rd or 4th dose on the new regimen.
• If the assay result is normal, and there is no change in dose or renal function, twice weekly monitoring of the pre-dose level is recommended. 

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Page last edited: 10/08/2009

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.

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