Guidelines from 2009 by pharmacists and infectious disease specialists recommend that only trough levels be performed, with a minimum of 10 mcg/mL considered necessary to control an infection. The guidelines recommend a therapeutic range of 15-20 mcg/mL for significant infections. However, many institutions have specific ranges depending on the site of infection and severity of infection.
If trough levels of vancomycin are above the minimum level, then the person should be receiving enough of the drug to be effective. If the person's infection is not responding to the treatment, then the health practitioner may either continue the drug for a longer period of time or consider other treatment options. If peak concentrations are below maximum levels, then the treated person is at less risk of developing nephrotoxicity and/or ototoxicity but may still experience either complication. Peak concentrations may vary, depending on the consistency of collection timing and on changing drug clearance rates.
If the trough and/or peak concentrations are above the maximum levels, then the person is at an increased risk of toxicity and the health practitioner may either alter the dose or the dosing schedule.
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Is there anything else I should know?
An intravenous vancomycin dose must be given slowly. People given the dose at a rapid rate are at an increased risk of developing "red man syndrome," a histamine reaction that causes flushing of the face, a rash on the upper body, and a significant drop in blood pressure.