Maternal Vancomycin

[Elvish, BSN, DNP, RN, NP]

Hey NICU peeps, just wondering something...

A mom asked me not too long ago (she was receiving IV Vanc) if the Vanc would have any effect on her baby's hearing after she delivered. I looked for the answer to her question myself and what I found suggested that there wasn't any long-term effect on hearing but some short-term hearing loss was found on a limited basis.

I'm wondering if you guys have seen any issues in moms that have gotten Vanc. I know we give Gent all the time in our nursery (both well-baby and NICU) and while no one gets a hearing test while receiving it, presumably for that reason, I haven't heard anyone saying it's associated with long-term hearing loss down the road, at least not in the dosages and 48hr cours we use. I guess my question isn't so much about Gent but Vanc. What, if anything, have you seen?

[Bortaz, MSN, RN]

How is vanco administered to adults? Over what time frame, I mean? We give it over an hour to our neonates, specifically to mitigate the ototoxicity. I'd reckon if similar administration is the norm with pregnant women, the risk would be minimal.

[Elvish, BSN, DNP, RN, NP]

This particular lady was getting hers over 1.25-2 hours, depending on her dose (which of course depended on her levels). She had been on it multiple times and ID was at that point considering putting her on it for a couple weeks.

Interesting input.

[NicuGal, MSN, RN]

Infectious Diseases in Critical Care - Jordi Rello, Marin Kollef - Google Books

This is what I found. I know that our ID tries not to use it on pregnant women unless they absolutely have to.

[Elvish, BSN, DNP, RN, NP]

I haven't seen it used a whole lot either - this was the first time, actually, but this pt had active MRSA in recurring genital abscesses that were not responding to ANYthing else. Interesting info.