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HelpTest ID VANTA Vancomycin, Trough, Serum
Ordering Guidance
In addition to this trough assay, both peak level and random testing are available.
1. Serum for a peak level should be drawn 1 hour after completion of dose; order VANPA / Vancomycin, Peak, Serum.
2. Serum for random testing should be ordered as VANRA / Vancomycin, Random, Serum.
Specimen Required
Collection Container/Tube: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions:
1. Draw specimen immediately prior to the next dose (within 30 minutes).
2. Centrifuge and aliquot serum into a plastic vial within 2 hours of collection.
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.
Useful For
Preferred test for monitoring vancomycin therapy
Monitoring trough concentrations drawn at steady-state in selected patients receiving vancomycin therapy
Method Name
Immunoassay
Reporting Name
Vancomycin, Trough, SSpecimen Type
Serum RedSpecimen Minimum Volume
0.25 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum Red | Refrigerated (preferred) | 14 days |
| Frozen | 365 days | |
| Ambient | 48 hours |
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), Streptococcus 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-lactam antibiotics.
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 above 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 analyses (eg, area under the curve: AUC studies) or for select patients.
Reference Values
Therapeutic: 10.0-20.0 mcg/mL
Cautions
As with any assay employing mouse antibodies, the possibility exists for interference by human antimouse 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
Report Available
Same day/1 to 2 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test has been cleared, approved, or is exempt by the US 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