• @theedtraumacist Vancomycin is a tricyclic glycopeptide antibiotic used to cover gram➕bacteria such as methicillin resistant Staphylococcus aureus. 💉
Vancomycin works by inhibiting bacterial cell wall synthesis by binding to D-alanyl-D-alanine cell wall precursors, inhibiting polymerization and preventing linkage to the glycopeptide polymer located within the bacteria’s cell wall.
When dosing vancomycin a couple of factors should be considered including the patient’s weight, renal function, and presenting disease state. It is normally
dosed at 15-20 mg/kg, and even higher for more severe infections (25-30 mg/kg in patients with sepsis, infective endocarditis, meningitis, etc. with a max dose depending on your hospital protocol).
In a study by Fuller and colleagues that reviewed vancomycin management in the ED, they reviewed 4441 doses of vancomycin given to patients with a weight measurement available. Vancomycin was dosed correctly in only 22.1% of patients 😧 with 71 % of patients being dosed below the recommended dose of 15-20 mg/kg 😱. Vancomycin dosing is not one size fits all and patient specific characteristics should be considered when dosing this medication. 💉
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