vancomycin levels are done 1. random (anytime) 2. trough (1/2 to 1 hr before the dose is given) 3. peak (1 hr after the dose is completed) .....now if the lab was done while the med was infusing that would be one explaination as to the high level....so i would find that out first...perhaps that pt has some renal involvement in which they really should be monitored extrememly close or not on vanco at all....most labs will give you a range ...from my exp they like to keep the level around 13-14, make sure you are always doing BUN and creatinine also.
Nov 6, '06
The levels let you know how the kidneys are getting rid of this potentially nephrotoxic drug. If after 12 hours there's a large amount left in the system, the md/pharmacist may adjust the dose lower, or increase the frequency.
Used to be that the standard was 10 or below the dose was changed. Now I've noticed our pharmacy has raised the level to about 15, and in one case it was even 20 or below we could continue to give the dose. They use height and weight, and creatinine in forumulating their decisions. Higher levels with low creatinines are apparently acceptable.
The level you mentioned is too high by anyone's standards.
As was mentioned above, what also goes into the decisions are the patient's creatinine.
Our pharmacists monitor our patients on Vanco and most of the docs let them dose it.