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HelpTest ID VANRA Vancomycin, Random, Serum
Useful For
Monitoring adequacy of drug concentration during vancomycin therapy
This test is used whenever a specimen is submitted or collected without collection timing information. Random levels may be ordered when attempting to determine when to dose vancomycin in patients with renal impairment or those undergoing dialysis.
Method Name
Immunoassay
Reporting Name
Vancomycin, Random, SSpecimen Type
Serum RedContainer/Tube: Red
top
Specimen Volume: 0.5 mL
Collection
Instructions:
1. Red-top tubes should be centrifuged and aliquoted within 2 hours
of collection.
2. Serum for a peak level should be drawn 1 hour after completion
of dose (order VANPA / Vancomycin, Peak, Serum). Serum for a trough
level should be drawn no more than 30 minutes prior to next dose
(order VANTA / Vancomycin, Trough, Serum).
Specimen Minimum Volume
0.25 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum Red | Refrigerated (preferred) | 14 days |
| Ambient | 14 days | |
| Frozen | 14 days |
Clinical Information
Vancomycin is an antibiotic used to treat infections caused by gram-positive organisms that are resistant to beta-lactam antibiotics, such as methicillin-resistant staphylococci (MRSA), Staphylococcus viridans group, penicillin/cephalosporin-resistant Streptococcus pneumoniae, and penicillin/ampicillin-resistant Enterococcus species. The oral formulation, which is not absorbed, is used in the treatment of pseudomembranous colitis caused by Clostridium difficile. Vancomycin is also used when patients are intolerant or allergic to beta lactams.
Vancomycin has been associated with nephrotoxicity and ototoxicity, although it appears that many of these reports reflected impurities in early formulations. Monitoring of vancomycin-related nephrotoxicity is recommended only for patients with reduced renal function, those receiving aggressive or prolonged vancomycin regimens, or those at high risk including patients comedicated with other nephrotoxic agents.
Trough concentrations are recommended for therapeutic monitoring of vancomycin, preferably acquired at steady state (just before fourth dose). To avoid development of resistance, vancomycin trough levels should remain >10.0 mcg/mL. Complicated infections require higher target levels, typically 15.0 to 20.0 mcg/mL. Peak concentrations do not correlate well to efficacy or nephrotoxicity, but may be useful for pharmacokinetic studies or for select patients.
Reference Values
Vancomycin, Trough
Therapeutic: 10.0-20.0 mcg/mL
Vancomycin, Peak
Therapeutic: 25.0-50.0 mcg/mL
Cautions
As with any assay employing mouse antibodies, the possibility exists for interference by human anti-mouse antibodies (HAMA) in the sample, which could cause falsely lowered results.
Unspecific binding of heterophilic antibodies from the sample to glucose-6-phosphate dehydrogenase of the reagent may lead to falsely lower test results in very rare cases (<10[-6]).
Day(s) Performed
Monday through Sunday; Continuously
Report Available
Same day/1 dayPerforming Laboratory
Mayo Medical Laboratories in Rochester
Test Classification
This test has been cleared or approved by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
80202