What is the recommended dosage of Vancomycin for Gram-positive cocci?

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From the Guidelines

Recommended Dosage of Vancomycin for Gram-positive Cocci

Vancomycin is typically administered at a dose of 15-20 mg/kg every 8-12 hours, with a maximum daily dose of 2 grams 1.

Key Considerations

  • The recommended dosage for patients with normal renal function is 1 gram every 12 hours, with adjustments made for patients with impaired renal function 1.
  • In cases of complicated skin and skin structure infections, a dose of 15-20 mg/kg every 8-12 hours is recommended, with treatment durations ranging from 7-14 days 1.
  • Trough monitoring is recommended for serious infections and patients who are morbidly obese, have renal dysfunction, or have fluctuating volumes of distribution 1.
  • Vancomycin trough concentrations of 15–20 lg/mL are recommended for serious infections, such as bacteremia, infective endocarditis, osteomyelitis, meningitis, pneumonia, and severe SSTI 1.
  • Weight-based dosing is particularly important in obese patients, who are likely to be underdosed when conventional dosing strategies of 1 g every 12 h are used 1.

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. Pediatric patients The usual intravenous dosage of vancomycin is 10 mg/kg per dose given every 6 hours. Neonates In pediatric patients up to the age of 1 month, the total daily intravenous dosage may be lower In neonates, an initial dose of 15 mg/kg is suggested, followed by 10 mg/kg every 12 hours for neonates in the 1st week of life and every 8 hours thereafter up to the age of 1 month.

The recommended dosage of Vancomycin for Gram-positive cocci is:

  • Adults with normal renal function: 2 g daily, divided as 500 mg every 6 hours or 1 g every 12 hours
  • Pediatric patients: 10 mg/kg every 6 hours
  • Neonates: initial dose of 15 mg/kg, followed by 10 mg/kg every 12 hours for the first week of life and every 8 hours thereafter up to 1 month of age 2

From the Research

Vancomycin Dosage for Gram-positive Cocci

The recommended dosage of Vancomycin for Gram-positive cocci is not explicitly stated in the provided studies. However, some studies mention the dosage of Vancomycin in comparison to other antibiotics:

  • A phase III trial compared ceftobiprole 500 mg with vancomycin 1 g, each administered twice daily for 7-14 days 3.
  • Another phase III trial compared ceftobiprole 500 mg every 8 hours with vancomycin 1 g every 12 hours plus ceftazidime 1 g every 8 hours 3.

Key Points

  • Vancomycin is used as a standard therapy for complicated skin and soft tissue infections caused by Gram-positive cocci 4, 5.
  • The dosage of Vancomycin is not explicitly stated in the provided studies, but it is mentioned as a comparator in several trials 3.
  • Daptomycin is another antibiotic used to treat Gram-positive cocci, and its dosage is mentioned in several studies 5, 6.
  • The choice of antibiotic and dosage depends on the specific infection, patient population, and other factors, and should be guided by clinical guidelines and expert opinion.

Dosage of Other Antibiotics

  • Daptomycin dosage:
    • 5 mg/kg for patients 12 to 17 years old 5
    • 7 mg/kg for patients 7 to 11 years old 5
    • 9 mg/kg for patients 2 to 6 years old 5
    • 10 mg/kg for patients 12 to 23 months old 5
    • 6 mg/kg/day for critically ill patients 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Ceftobiprole: a review of a broad-spectrum and anti-MRSA cephalosporin.

American journal of clinical dermatology, 2008

Research

[Daptomycin--a new antibiotic for the treatment of skin and soft tissue infections].

Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke, 2006

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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