Vancomycin (Vancocin)
Glycopeptide antibiotic and cornerstone of MRSA treatment. Binds D-Ala-D-Ala terminus of peptidoglycan precursors, blocking transpeptidation and transglycosylation in Gram-positive bacterial cell wall synthesis. IV only for systemic infections (oral vancomycin is not absorbed — used exclusively for C. difficile colitis). Renally cleared ~80-90% unchanged — therapeutic drug monitoring (TDM) of trough levels essential (target 10-20 mg/L). Nephrotoxicity risk increases with troughs >20 mg/L or concurrent aminoglycosides. Red man syndrome from histamine release with rapid IV infusion — prevent by infusing over ≥60 min. Ototoxicity rare but irreversible.
Projected serum levels — 1k mg, twice daily
Maintenance schedule: 1k mg twice daily (iv).
Modeled steady state after ~1 days: peak ≈ 585 mg, trough ≈ 117 mg body load. Population-based estimate over 15 days for a 1k mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.
Key facts
- Category
- Antibiotic
- Route modeled
- IV
- Model confidence
- inferred
- Half-life
- 5 h
- Common dose
- 1k mg
- Suggested maximum
- 3k mg/day
- Reference dose range
- 500–3k mg (single dose)
- Suggested cadence
- twice daily
- Validated against
- 1k mg iv — Cmax 30 mg/L at 1 h
Research behind this entry
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Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children
Foundational IDSA MRSA guidelines establishing vancomycin as first-line therapy for severe MRSA infections, recommending trough levels of 15-20 mg/L for bacteremia/endocarditis/osteomyelitis, AUC/MIC-guided dosing, and…
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Therapeutic monitoring of vancomycin in adult patients: a consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists
Definitive consensus guideline on vancomycin TDM, establishing target troughs of 15-20 mg/L for serious MRSA infections, AUC/MIC ≥400 as pharmacodynamic target, and outlining nephrotoxicity risk factors including…
2 published studies referenced in the app, each with a plain-language summary.