From the FDA Drug Label
DOSAGE AND ADMINISTRATION Infusion-related events are related to both the concentration and the rate of administration of vancomycin. Patients with Normal Renal Function Adults The usual daily intravenous dose is 2 g divided either as 500 mg every 6 hours or 1 g every 12 hours. Patients with Impaired Renal Function and Elderly Patients Dosage adjustment must be made in patients with impaired renal function.
The recommended dosage of Vancomycin for enterococcus UTI is not explicitly stated in the drug label. However, based on the provided information, the usual daily intravenous dose for adults with normal renal function is 2 g divided either as 500 mg every 6 hours or 1 g every 12 hours 1.
- For patients with impaired renal function, dosage adjustment is necessary, and the dose can be calculated using the provided table or formula.
- It is essential to note that vancomycin serum concentrations should be monitored, especially in seriously ill patients with changing renal function.
- The initial dose should be no less than 15 mg/kg, even in patients with mild to moderate renal insufficiency.
From the Research
For treating enterococcus urinary tract infections (UTIs), vancomycin is typically dosed at 15-20 mg/kg IV every 12 hours, with a usual adult dose of 1 gram IV every 12 hours for patients with normal renal function. The duration of therapy is generally 7-14 days depending on infection severity. Dosage adjustments are necessary for patients with renal impairment, and trough levels should be monitored (aim for 15-20 mg/L for serious infections) 2. Vancomycin is primarily used for enterococcal UTIs when the organism is resistant to first-line agents like ampicillin or when the patient has significant allergies. It's essential to note that vancomycin has poor urinary concentration, so it's not ideal for uncomplicated UTIs. Alternative agents like linezolid or daptomycin may be considered in certain situations, as linezolid has shown efficacy in enterococcal UTI treatment 2. Cultures and susceptibility testing should guide therapy, and consultation with an infectious disease specialist is recommended for complicated cases or vancomycin-resistant enterococci (VRE) 3, 4.
Some key points to consider when treating enterococcal UTIs include:
- The importance of removing indwelling urinary catheters to prevent further infection 5
- The use of alternative agents like linezolid or daptomycin in certain situations, such as vancomycin-resistant enterococci 3, 4
- The need for dosage adjustments and trough level monitoring in patients with renal impairment 2
- The consideration of consultation with an infectious disease specialist for complicated cases or vancomycin-resistant enterococci (VRE) 3, 4
Overall, the treatment of enterococcal UTIs requires careful consideration of the patient's specific situation and the use of appropriate antimicrobial therapy, as well as consultation with specialists when necessary.