Vancocin

Adult Dosing .

Dosage forms:  CAP: 125 mg, 250 mg

C. difficile infection

[non-fulminant (off-label)]

Dose: 125 mg PO q6h x10 days; Info: for 1st episode

[fulminant (off-label)]

Dose: 500 mg PO/NG q6h; Info: 1st-line agent; may give w/ metronidazole IV; consider adding vancomycin 500 mg in 100 mL NS retention enema PR q6h if complete ileus

[1st recurrence (off-label)]

Dose: 125 mg PO q6h x10-14 days, then 125 mg PO q12h x7 days, then 125 mg PO qd x7 days, then 125 mg PO q2-3 days x2-8wk; Info: may give 125 mg PO q6h x10 days if metronidazole initial regimen

[2 or more recurrences (off-label)]

Dose: 125 mg PO q6h x10-14 days, then 125 mg PO q12h x7 days, then 125 mg PO qd x7 days, then 125 mg PO q2-3 days x2-8wk; Alt: 125 mg PO q6h x10 days, then rifaximin x20 days

enterocolitis, staphylococcal

[500-2000 mg/day PO divided q6-8h x7-10 days]

renal dosing

[see below]

renal impairment: no adjustment; Info: consider monitoring serum levels if potential for systemic absorption

HD/PD: not defined

hepatic dosing

[not defined]

Peds Dosing .

Dosage forms:  CAP: 125 mg, 250 mg

C. difficile infection

[non-severe (off-label)]

Dose: 40 mg/kg/day PO divided q6h x10 days; Max: 125 mg/dose; Info: for 1st episode or 1st recurrence; 1st-line agent

[severe or fulminant (off-label)]

Dose: 40 mg/kg/day PO/PR divided q6h x10 days; Max: 500 mg/dose; Info: for 1st episode; 1st-line agent; may give w/ metronidazole IV; may mix in 100 mL NS retention enema and give PR

[2 or more recurrences (off-label)]

Dose: 10 mg/kg/dose PO q6h x14 days, then 10 mg/kg/dose PO q12h x7-14 days, then 10 mg/kg/dose PO qd x7-14 days, then 10 mg/kg/dose PO q2-3 days x2-8wk; Max: 125 mg/dose; Alt: 10 mg/kg/dose PO q6h x7 days, then 10 mg/kg/dose PO q8h x7 days, then 10 mg/kg/dose PO q12h x7 days, then 10 mg/kg/dose PO qd x7 days, then 10 mg/kg/dose PO q48h x7 days, then 10 mg/kg/dose PO q72h x7 days; 10 mg/kg/dose PO q6h x14 days, then rifaximin x14 days or nitazoxanide x10 days

enterocolitis, staphylococcal

[40 mg/kg/day PO divided q6-8h x7-10 days]

Max: 500 mg/dose, 2000 mg/day

renal dosing

[not defined]

renal impairment: consider adult renal dosing for guidance

HD/PD: not defined

hepatic dosing

[not defined]