Reference Intervals
Adults – 15 years and older
For all samples (trough or random):
Refer to CMH Guideline “Vancomycin – intravenous or oral Use (Adults) “.
Pharmacists advise in notes if NextDose Bayesian forecasting of AUC or trough monitoring is recommended.
Next Dose: Pharmacists recommend dose adjustments, levels cannot be interpreted on their own, please do not adjust without discussion with pharmacy.
- Peak or mid dose levels which will often be greater than 20mg/L (not clinically concerning).
- If the timing of the level corresponds to a true trough level (i.e. 0 to 2 hours before the next dose), vancomycin is required to be withheld if it is greater than 25mg/L, or the dose reduced if the level is 21 – 25mg/L.
Trough monitoring:
Pre-dose (trough) concentration target is 15-20mg/L. See guideline for dose adjustment.
Children – < 15 years
For all samples (trough or random):
Use NextDose Bayesian AUC24 for next dose prediction in paediatric patients.
Pharmacists recommend dose adjustments, levels cannot be interpreted on their own, please do not adjust without discussion with pharmacy.
- Peak or mid dose levels which will often be greater than 20mg/L (not clinically concerning).
- If the timing of the level corresponds to a true trough level (i.e. 0 to 2 hours before the next dose), vancomycin is required to be withheld if it is greater than 25mg/L, or the dose reduced if the level is 21 – 25mg/L.
NICU/SCBU babies
Trough monitoring:
- Target trough concentration for intermittent dosing regimen is 15 – 20mg/L. Consult neonatal “Vancomycin – Intermittent” for dose adjustment advice.
- For continuous dosing regimen, consult neonatal “Vancomycin – Continuous” guideline for dose adjustment advice.
Random sample:
Refer to neonatal vancomycin guideline for guidance.
Test Method
Principle: homogeneous enzyme immunoassay technique
Analyser: Roche Diagnostics Cobas c503
Reagent: VANC3
Uncertainty of Measurement
10% at 6.5 mg/L
5% at 33 mg/L