Vancomycin

CPT Code(s):
80202

Turnaround Time:
24 hours

Specimen Requirements

Preferred Specimen:
Serum, (Red Top Tube)

Minimum Volume:
1.0 mL

Transport Container:
Plastic Transport Tube

Transport Temperature:
Room Temperature

Collection Instructions: Serum collected in plain Red Top Tube. Allow blood to clot prior to centrifugation. Separate serum from cells within 45 minutes of collection. Pipette serum into plastic transport tube.

Rejection Criteria:
Citrate, Fluoride,Sodium Heparin, or EDTA plasma specimen; specimen received on red cells gross hemolysis; lipemia; improper labeling

Stability Criteria

Room Temperature:
2 days

Refrigerated:
7 days

Frozen:
30 days

Clinical Significance

Vancomycin is a glycopeptide antibiotic that is primarily used to treat serious, life-threatening infections caused by Gram-positive bacteria that are resistant to other antibiotics. Its clinical significance is substantial due to its effectiveness in treating a variety of severe infections. Here are key points highlighting its clinical importance:

Treatment of MRSA Infections

Methicillin-Resistant Staphylococcus aureus (MRSA): Vancomycin is often the antibiotic of choice for treating infections caused by MRSA, which are resistant to most other antibiotics.

Severe Skin Infections: It is commonly used to treat serious skin and soft tissue infections, including cellulitis and abscesses caused by MRSA.

Treatment of Enterococcal Infections

Vancomycin-Resistant Enterococci (VRE): Although vancomycin is effective against many strains of Enterococci, resistance has been emerging, and treatment of VRE often requires alternative therapies.

Treatment of Clostridioides difficile Infections

C. difficile Colitis: Oral vancomycin is used as a treatment for severe cases of C. difficile infection, especially in patients who do not respond to metronidazole.

Use in Penicillin-Allergic Patients

Alternative for Allergic Patients: Vancomycin serves as an alternative for patients allergic to beta-lactam antibiotics, including penicillins and cephalosporins, especially for serious infections.

Prophylactic Use in Surgery

Surgical Prophylaxis: It is used prophylactically in surgeries, particularly those involving implantation of prosthetic devices, to prevent infections by Gram-positive bacteria.

Treatment of Bacteremia and Endocarditis

Bloodstream Infections: Vancomycin is crucial in treating bacteremia (blood infections) and endocarditis (infection of the heart valves) caused by resistant Gram-positive organisms.

Pharmacokinetics and Administration

Intravenous Administration: For systemic infections, vancomycin is typically administered intravenously.

Oral Administration: For gastrointestinal infections like C. difficile, it is administered orally.

Therapeutic Drug Monitoring: Due to its narrow therapeutic index, vancomycin levels in the blood are often monitored to avoid toxicity and ensure effective dosing.

Side Effects and Resistance

Nephrotoxicity and Ototoxicity: Potential side effects include kidney damage and hearing loss, especially with prolonged use or high doses.

Resistance: The emergence of vancomycin-resistant organisms, such as VRE, poses a significant challenge in clinical settings, necessitating the development and use of alternative treatments.

Conclusion

Vancomycin remains a cornerstone in the treatment of serious Gram-positive infections, particularly those caused by antibiotic-resistant organisms. Its use, however, requires careful monitoring due to potential toxicity and the increasing incidence of resistance. The development of new antibiotics and alternative treatments is essential to address these challenges and ensure continued effective management of resistant infections.