What does vancomycin trough level mean?
What does vancomycin trough level mean?
This test is used to monitor levels of the antibiotic vancomycin in the blood. When a person takes a dose of vancomycin, the amount in the blood rises for a period of time, peaks, and then begins to fall, usually reaching its lowest level, or trough, just before the next dose.
What causes a high vancomycin trough?
Several risk factors have been identified for VIN, which high trough vancomycin level (especially >20 mg/L) or doses (>4 g/day), concomitant use of nephrotoxic agents, prolonged therapy (more than 7 days), and admission to an intensive care unit (especially prolonged stay) are the most common ones (1-4, 14).
When do you check vancomycin trough levels?
Trough: just before 4th dose of a new regimen (prior to 3rd dose for dosing intervals ≥ 24 hours or changing renal function) – Trough levels should be obtained within 30 minutes before the next scheduled dose. – Weekly vancomycin levels should be obtained for long-term vancomycin use with stable renal function.
Why do we monitor Vanco troughs?
Vancomycin can also be given before certain surgeries to prevent an infection. Monitoring the level of vancomycin is important because its effectiveness relies on keeping blood levels above a minimum concentration for the entire duration of therapy (also referred to as total drug exposure).
What color tube is Vanco trough?
Red
Red-top tube, lavender-top (K2- or K3- EDTA) tube, or green-top (heparin) tube. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel.
How often does Vanc trough occur?
Subsequent trough levels: o With dosage change: trough should be taken at new steady state* as described above. o Once target trough achieved: trough should be taken every 7-10 days in hemodynamically stable patients; may need more frequently if hemo-dynamically unstable, renal function changing, or patient is on …
Do you refrigerate Vanco trough?
Refrigerated (preferred) or frozen. Specimen stability: Room temperature: 48 hours.
How are Vanco clearances calculated?
Clearance
- CLvanco (mL/min/kg) = ([CrCl × 0.0075] + 0.04)
- Vd = 0.47 L/kg. Vd was estimated using an adjusted body weight (ABW).
What is a normal trough level for vancomycin?
If the trough is above 15-20 mg/L, consider decreasing the dose and/or lengthening the dosing interval If trough level is significantly elevated (i.e. greater than 25 mg/L) hold vancomycin and use repeat levels to determine when to restart vancomycin and new dosing regimen
When are vancomycin troughs indicated in dialysis?
Usually only vancomycin troughs are needed. Random levels may be obtained on patients with poor renal function who only receive intermittent or post-dialysis dosing. At minimum, levels should be obtained for all patients by 72 hours of therapy and at least weekly thereafter. Many patients will require more frequent monitoring.
What is the goal of the vancomycin blood test?
The goal is to find a dose for vancomycin that is both safe and effective. Vancomycin blood levels are drawn at timed intervals to measure drug levels during treatment. Vancomycin has a narrow therapeutic index, which is the ratio between the toxic and effective dose of medication.
What are the 2020 vancomycin Therapeutic Guidelines for complicated infections?
Maintain trough serum vancomycin concentrations of 15-20mg/L for complicated infections The 2020 vancomycin therapeutic guidelines recommends a move away from monitoring vancomycin trough levels to targeting an AUC 24 :MIC (24-hour area under the curve (AUC) to minimum inhibitory concentration ratio).
