001.pdf - 1 Vancomycin Monitor Intravenous Periodic renal...

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1- Vancomycin: ü Monitor: Intravenous: Periodic renal function tests, urinalysis, WBC; serum trough vancomycin concentrations in select patients (eg, aggressive dosing, unstable renal function, concurrent nephrotoxins, prolonged courses). Suggested frequency of trough vancomycin concentration monitoring (Rybak, 2009): Hemodynamically stable patients: Draw trough concentrations at least once- weekly. Hemodynamically unstable patients: Draw trough concentrations more frequently or in some instances daily. Prolonged courses (>3-5 days): Draw at least one steady-state trough concentration; repeat as clinically appropriate. Note: Drawing >1 trough concentration prior to the fourth dose for short course (<3 days) or lower intensity dosing (target trough concentrations <15 mcg/mL) is not recommended. ü Dosing : IV: 15 to 20 mg/kg/dose (based on actual body weight) every 8 to 12 hours (for empiric therapy, use in combination with a third-generation cephalosporin; for patients >50 years, include ampicillin); duration of therapy
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