- Body system
- Anti-infectives
- Brand names
- Vancocin, Firvanq
What is Vancomycin used for?
- MRSA and other serious gram-positive infections (IV)
- C. difficile infection (oral only: it is not absorbed from the gut)
How Vancomycin works
Glycopeptide: blocks bacterial cell wall synthesis at a different step than beta-lactams.
Common side effects
- Vancomycin infusion reaction: flushing, itching and rash of the face, neck and upper body, sometimes hypotension (formerly called red man syndrome)
- Nephrotoxicity
- Ototoxicity
- Phlebitis
Report right away
- Reduced urine output
- Ringing in the ears, hearing loss or dizziness
- Flushing or itching during the infusion
Nursing considerations for Vancomycin
- Infuse over at least 60 minutes (longer for larger doses, often no faster than 10 mg per minute). If an infusion reaction occurs, stop or slow the infusion and notify the prescriber.
- Monitor BUN, creatinine and urine output, and drug levels as ordered; many hospitals now use AUC-guided dosing rather than trough-only targets.
- Assess the IV site often for phlebitis.
Patient teaching
- Report hearing changes or less urine.
- Oral vancomycin treats C. difficile in the gut and does not treat infections elsewhere.
This card does not list doses. Use the prescriber's order, the product label and a current drug reference for dosing, and follow your facility's policies.
Vancomycin (glycopeptides) practice questions
NCLEX-style questions on the class Vancomycin belongs to.
3 questions. Choose an answer to see the rationale.
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A patient develops flushing and a red rash on the face and neck during a vancomycin infusion. What is the first action?
Show answer
Answer A: Stop or slow the infusion and notify the provider This is a vancomycin infusion reaction, caused by infusing too fast. Slowing or stopping the infusion and an antihistamine as ordered usually resolve it.
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When should a vancomycin trough level be drawn?
Show answer
Answer A: Just before the next dose A trough is the lowest level, measured right before the next dose.
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Which lab result best indicates vancomycin nephrotoxicity?
Show answer
Answer D: Rising serum creatinine A rising creatinine and falling urine output suggest kidney injury.
Frequently asked questions
What is Vancomycin used for?
MRSA and other serious gram-positive infections (IV); C. difficile infection (oral only: it is not absorbed from the gut).
What drug class is Vancomycin?
Vancomycin belongs to the class vancomycin (glycopeptides). Glycopeptide: blocks bacterial cell wall synthesis at a different step than beta-lactams.
What are the nursing considerations for Vancomycin?
Infuse over at least 60 minutes (longer for larger doses, often no faster than 10 mg per minute). If an infusion reaction occurs, stop or slow the infusion and notify the prescriber. Monitor BUN, creatinine and urine output, and drug levels as ordered; many hospitals now use AUC-guided dosing rather than trough-only targets.
What should patients report while taking Vancomycin?
reduced urine output; ringing in the ears, hearing loss or dizziness; flushing or itching during the infusion.