Vancomycin
Vancomycin is a glycopeptide antibacterial.
Group
Glycopeptide antibacterial
Mechanism of Action
Binds D-alanyl-D-alanine cell-wall precursors and inhibits susceptible gram-positive bacteria.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Resistant gram-positive infection | 15 mg/kg | IV | Every 6–8 h | Start every 8 hours; if exposure inadequate, shorten to 6 hours using monitoring. Administer by slow infusion. |
| Antibacterial infusion — Loading | 3.5 mg/kg | IV | Once | |
| Antibacterial infusion — Maintenance | 1.5 mg/kg/hour | IV | Continuous | Dilute in 5% dextrose. |
| Clostridioides difficile enterocolitis | 10–20 mg/kg | PO | Every 6 h | Up to 7 days; Reported 5-7 days; oral drug acts locally and is not systemic treatment. |
| Skin urinary or soft tissue infection | 10–20 mg/kg | IV | Every 12 h | Up to 10 days; Reported 7-10 days; slow infusion. |
Cats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Resistant gram-positive infection | 12–15 mg/kg | IV | Every 8 h | Slow IV infusion. |
| Resistant gram-positive infection | 15 mg/kg | IV | Every 6–8 h | Over 30-60 minutes; therapeutic and renal monitoring. |
Horses
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Resistant gram-positive infection | 4.3–7.5 mg/kg | IV | Every 8 h | Infuse over 1 hour. |
Indications
- Serious resistant susceptible gram-positive infection
- Clostridioides difficile enterocolitis
- Skin urinary or soft tissue infection
- Resistant gram-positive infection
Contraindications
- Avoid rapid IV injection; IM and SC are painful and inappropriate for routine systemic therapy.
Interactions
- Incompatible with many co-infused medicines; other nephrotoxins increase renal risk.
Adverse effects
- Renal injury, infusion reactions and possible neutropenia.
Toxicity
Overdose increases renal and auditory toxicity risk. Oral absorption may increase with severe intestinal inflammation; monitor renal function and systemic exposure.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Vancomycin 500 mg vial | Injection | 500 mg / vial | IV |
| Vancomycin 1000 mg vial | Injection | 1000 mg / vial | IV |
| Vancomycin 5000 mg vial | Injection | 5000 mg / vial | IV |
| Vancomycin 10000 mg vial | Injection | 10000 mg / vial | IV |
Monitoring and Administration
Use slow IV infusion and therapeutic drug monitoring; assess creatinine/BUN and urinalysis. Reported proposes AUC/MIC above 400 or individualized trough monitoring; veterinary targets are less established than human targets.
Use a separate compatible infusion solution; reconstituted product stability depends on the actual formulation.
Equine regional limb perfusion is described as 300 mg diluted to 0.5%; this is a local tourniquet-based procedure, not a systemic IV dose.
Canine intermittent infusion: deliver over 30-60 minutes; the reported guidance also describes an approximately 10 mg/min maximum practical administration rate. Avoid rapid bolus injection.
500-mg and 1-g injectable vials are reconstituted with 10 and 20 mL sterile water respectively, then further diluted in at least 100 or 200 mL compatible infusion fluid before use. These are preparation instructions; added diluent volume is not assumed to equal exact final volume for automatic mL calculation.