Vancomycin is administered as a slow intravenous infusion at a rate of no more than 10 mg / min for at least 60 minutes. The concentration of the prepared solution of vancomycin should not exceed 5 mg / ml.
Adults: 0.5 g or 7.5 mg / kg every 6 hours or 1 g or 15 mg / kg every 12 hours.
Children: Newborn children up to 7 days of life - the initial dose of 15 mg / kg body weight, then - 10 mg / kg every 12 hours; starting from the second week of life - 10 mg / kg every 8 hours; children from 1 month and older - 10 mg / kg every 6 hours.
Patients with impaired renal excretory function require correction of the dosing regimen taking into account the values of creatinine clearance (CK).
Correction can be carried out by increasing the intervals between administrations, or by reducing the single dose of the drug:
Correction by increasing the intervals between the administrations:
| Creatinine clearance (ml / min) | Vancomycin Dose | Interval between administrations |
| more than 80 | 1 g | 12 h |
| 80-50 | 1 g | 1-3 days |
| 50-10 | 1 g | 3-7 days |
| less than 10 | 1 g | 7-14 days |
Correction of a single dose:
| Creatinine clearance (ml / min) | Dose of vancomycin (mg / day) |
| 100 | 1545 |
| 90 | 1390 |
| 80 | 1235 |
| 70 | 1080 |
| 60 | 925 |
| 50 | 770 |
| 40 | 620 |
| 30 | 465 |
| 20 | 310 |
| 10 | 155 |
This table can not be used to determine the dose of the drug in anuria.Such patients should be given an initial dose of 15 mg / kg body weight to quickly create therapeutic concentrations of the drug in the serum. The dose required to maintain a stable drug concentration is 1.9 mg / kg / day. Patients with severe renal failure should be administered maintenance doses of 250-1000 mg once every few days.
With anuria, a dose of 1 g is recommended every 7-14 days.
When only the concentration of serum creatinine is known, the following formula can be used to calculate the creatinine clearance:
for men: body weight (kg) x (140 - age (years)) / 72 x serum creatinine concentration (mg / dL)
for women: the result is multiplied by 0.85.
Preparation of a solution for intravenous administration
Solution for injection is prepared immediately before the administration of the drug. To do this, 10 ml are added to the bottle with a dry, sterile preparation of 0.5 g dosage, with a dosage of 1 g - 20 ml of sterile water for injection (concentration of the solution is 50 mg / ml).
REQUIRED FURTHER DILUTION of the prepared solution.
Prepared solutions of vancomycin before administration are subject to further dilution to a concentration of not more than 5 mg / ml.The required dose, diluted in the above manner, vancomycin, should be administered by intravenous infusion for at least 60 minutes.
As solvents, a 5% solution of dextrose (glucose) for injection or 0.9% solution of sodium chloride for injection can be used: for 0.5 g - 100 ml and for 1 g - 200 ml.
Before injection, the prepared parenteral solution should be visually inspected, if possible, for mechanical impurities and discoloration.
Solutions prepared on the basis of a 5% solution of dextrose (glucose) or 0.9% solution of sodium chloride, can be stored in the refrigerator (2-8 ° C) for 14 days without significant loss of activity.
Preparation of a solution for ingestion and its use
The daily dose for adults is 0.5-2 g, divided into 3-4 doses, for children - 40 mg / kg, divided into 3-4 doses. The maximum daily intake for adults and children is 2 g.
The appropriate dose is dissolved in 30 ml of water and the patient is given a drink or injected through a probe. To improve the taste of the solution, ordinary food syrups can be added to it.The duration of treatment is 7-10 days.