-Empirical treatment of septicemia caused by susceptible strains of methicillin-resistant staphylococci in patients who are allergic to penicillin, failed to respond/cannot receive other drugs (e.g., penicillins, cephalosporins), and/or to treat organisms that are resistant to other drugs Pediatric Infectious Diseases Society (PIDS) and IDSA Recommendations: Adult Vancomycin Loading Dose Guidelines for the ED Why a loading dose? -Culture-negative peritonitis: 2 weeks T1 - The Role of a Single Dose of Vancomycin in Reducing Clinical Sepsis in Premature Infants Prior to Removal of Peripherally Inserted Central Catheter. -External drain output 100 to 150 mL/day: Once a day Consecutive levels . -Treatment of enterocolitis caused by S aureus (including MRSA) Uses: Initial dose: 15 mg/kg IV ONCE Clipboard, Search History, and several other advanced features are temporarily unavailable. -Alternative drug (with linezolid with/without gentamicin) for the treatment of VISA infections with MICs of 4 to 16 mcg/mL -Drug of choice for the treatment of non-life-threatening infection without signs/symptoms of sepsis (e.g., skin infection, cellulitis) when rates of MRSA colonization and infection in the community are substantial. With few exceptions coagulase-negative staphylococci (CoNS) have remained the most frequent causative agents of neonatal late onset sepsis -Doses should be determined by patient-specific factors (e.g., obesity, age). -Alternative treatment of MSSA in patients with serious penicillin and cephalosporin allergy Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Patients with slit ventricles: 5 mg via intraventricular route (plus gentamicin) -OTHER: Hearing tests, especially in patients given high doses and/or those over 60 to 65 years of age AAP Recommendations: From about 250 patients receiving serum vancomycin Use: -Maximum dose: 2 g/dose The primary objective of this study was to compare nephrotoxicity in emergency department (ED) sepsis patients who received vancomycin at high doses (>20 mg/kg) versus lower doses (20 mg/kg). -Alternative drug (with sulfamethoxazole-trimethoprim) for the treatment of VISA infections with MICs of 4 to 16 mcg/mL International Society for Peritoneal Dialysis (ISPD) Recommendations: -Drug of choice for the treatment of life-threatening infections (e.g., septicemia) Pediatric patients: 10 mg/kg IV every 6 hours There is not enough evidence to Median initial vancomycin dose was 15 mg/kg; median vancomycin trough concentration was 17 mg/L. o Patients with altered volume of distribution or clearance of vancomycin (e.g. Initial dose: 15 mg/kg IV ONCE Frequency of dosing: Optimization of Intermittent Vancomycin Dosage Regimens for Thai Critically Ill Population Infected by MRSA in the Era of the "MIC Creep" Phenomenon. Vancomycin level should be obtained 24 hours after the first dose is given. -Doses should be determined by patient-specific factors (e.g., obesity, age). 8 to 30 days and less than 1200 g: 15 mg/kg IV every 24 hours -Treatment of patients with brain abscess, subdural empyema, and/or spinal epidural abscess -Patients with necrotizing infections may require up to a 13 mg/kg dose given IV every 8 hours plus piperacillin. If vancomycin is used, -Staphylococci infection: 6 weeks -Some urologic procedures (e.g., clean surgery involving implanted prosthesis), AAP Recommendations: Adult Dosing Recommendations: Loading dose: Use a loading dose in: o Serious infections where rapid attainment of target trough level of 15-20 mg/L is desired, e.g. Goal of this target attainment are Associated with potentially toxic trough levels potentially toxic levels. Organisms are not found, discontinuation of treatment in Critically Ill patients appears hazy, or particles! 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