Vancomycin
For MRSA and serious gram-positive infections. IV dosing by weight with levels; oral vancomycin treats C. difficile.
On this page
Uses
- MRSA infections: line infections, severe skin infection, septic arthritis, pneumonia.
- Penicillin-allergic patients with serious gram-positive infection.
- Oral: C. difficile infection.
Adult dose
| Indication | Dose |
|---|---|
| IV loading dose (severe) | 25–30 mg/kg once |
| IV maintenance | 15–20 mg/kg every 8–12 hours, adjusted to trough levels (usually 10–20 mg/L, per local protocol) |
| Oral (C. difficile) | 125 mg 4 times daily for 10 days |
Children's dose
IV 15 mg/kg every 6–8 hours, adjusted to levels (specialist).
Kidney and liver
Adjust by levels and creatinine; give less often in kidney impairment.
Pregnancy and breastfeeding
Use when needed with level monitoring.
Side effects and cautions
- Infuse slowly (no faster than 10 mg/min) to avoid "red man" flushing.
- Nephrotoxicity and ototoxicity: monitor creatinine and levels.
Frequently asked questions
What is the oral vancomycin dose for C. difficile?
125 mg four times daily for 10 days.
Why is vancomycin infused slowly?
Fast infusion causes flushing, itching and low BP (red man syndrome).
Used in these guides
Sources
Doses on this page are typical doses from the sources above. Always confirm with a current drug reference, the product leaflet and your hospital protocol, especially in children, pregnancy and kidney or liver disease.
For FCPS Part 1
Revising for FCPS Part 1? Vancomycin is covered in our textbook chapter Antibacterial drugs, with practice MCQs.