Premedication: Diphenhydramine 50 mg IV and hydrocortisone 100 mg IV 15 minutes prior to initiation of protocol, then every 6 hours throughout protocol |
Infusion number | Dilution | Vancomycin dose (mg) | Concentration (mg/mL) |
1 | 1:10,000 | 0.02 | 0.0002 |
2 | 1:1000 | 0.2 | 0.002 |
3 | 1:100 | 2 | 0.02 |
4 | 1:10 | 20 | 0.2 |
5 | Standard | 500 | 2 |
Preparation |
- Prepare a standard bag of 500 mg vancomycin in 250 mL NS or D5W; label as infusion number 5, vancomycin 2 mg/mL.
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- Draw up 10 mL of the standard vancomycin 2 mg/mL preparation and place in 100 mL bag of NS or D5W; label as infusion number 4, vancomycin 0.2 mg/mL.
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- Draw up 10 mL of the 0.2 mg/mL solution and place in a 100 mL bag of NS or D5W; label as infusion number 3, vancomycin 0.02 mg/mL.
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- Draw up 10 mL of the 0.02 mg/mL solution and place in a 100 mL bag of NS or D5W; label as infusion number 2, vancomycin 0.002 mg/mL.
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- Draw up 10 mL of the 0.002 mg/mL solution and place in a 100 mL bag of NS or D5W; label as infusion number 1, vancomycin 0.0002 mg/mL.
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Infusion rate directions |
Initiate infusion rate at 0.5 mL/minute (30 mL/hour) and increase by 0.5 mL/min (30 mL/hour) as tolerated every 5 minutes to a maximum rate of 5 mL/minute (300 mL/hour). If pruritus, hypotension, rash, or difficulty breathing occurs, stop infusion and reinfuse the previously tolerated infusion at the highest tolerated rate. This step may be repeated up to 3 times for any given concentration. |
Upon completion of infusion number 5, immediately administer the required dose of vancomycin in the usual dilution of NS or D5W over 2 hours. Decrease rate if patient becomes symptomatic or, alternatively, increase rate if patient tolerated dose. Administer diphenhydramine 50 mg orally 60 minutes prior to each dose. |