1. Monitoring parameters:
Obtain at steady-state (approximately four half lives) and then weekly during therapy.
|•||BUN and serum creatinine|
Measure every two days, or every day in unstable renal function.
Weigh patient every two to seven days.
Measure and monitor urine output daily.
|•||Baseline and weekly audiograms. |
|•||Check for signs of phlebitis daily. |
2. Therapeutic serum concentrations (mcg/ml)
Although considerable controversy exists, the following target serum levels are currently recommended:
|•||Routine peak level monitoring is no longer recommended |
|•||For serious infections, such as bacteremia, infective endocarditis, osteomyelitis, meningitis, pneumonia, and severe SSTI (eg, necrotizing fasciitis) due to MRSA, vancomycin trough concentrations of 15–20 mcg/ml are recommended.|
|•||For less serious infections such as skin and soft tissue infections, trough concentrations of 10-20 mcg/ml are recommended.|