Vancomycin in HD order set

[Darlene Llewellyn]

Hi…I am revamping our Vancomycin pre-printed order…wondering if anyone is willing to share their PPO…I am also interested in knowing at what concentration do you administer Vancomycin via fistula (technically, this is peripheral administration…we administer at a lower concentration compared to central administration?)…thank you in advance

[Lori Wazny]

Here is the link to our Manitoba Renal Program preprinted orders. See under Catheter related bacteremia for vanco: https://www.kidneyhealth.ca/mrp-staff-portal/mrp-order-sets/

Dilution (not different for fistula vs catheter) – IV Intermittent (for Hemodialysis Patients – administered in dialysis unit):
Dilute 500 mg in 100 mL NS and administer over the last 30 minutes of dialysis
Dilute 750 mg or 1000 mg doses in 100 mL NS and administer over the last 60 minutes of dialysis
Dilute doses greater than 1000 mg and up to 1500 mg in 100 mL NS and administer over the last 90 minutes of dialysis

Lori Wazny, Pharm.D.

[Derrick Soong]

As a follow up …

Windsor reconstitutes vanco typically to a max concentration of 10mg/mL (1000 mg in 100 mL NS, 1500 mg in 150 mL NS, 2000 mg in 200 mL NS) and infuses anything less than 1500 mg over the last hour of dialysis. Any vanco 1500 mg or more, we infuse over the last 90 minutes of dialysis.

Hope that helps.

– Derrick

[Author]

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