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Test Code BLOD0545 Vancomycin, Peak, Plasma or Serum

Methodology

Particle-Enhanced Turbidimetric Inhibition Immunoassay (PETINIA)

Useful for antimicrobial drug monitoring.

Performing Laboratory

Bozeman Health Laboratory Services

Specimen Requirements

Specimen Type: Plasma or serum
Container/Tube: Light-green top (lithium heparin gel), red top, or gold top
Specimen Volume: 1 mL
Specimen Minimum Volume: 0.5 mL

Collection Instructions:

1. Specimen for a peak level should be drawn 30 to 60 minutes after administration of dose.
2. Specimen for a trough level should be drawn immediately prior to next dose.

3. Spin down within 2 hours of draw, remove plasma or serum from cells.

4. Label specimen as plasma or serum.

5. If there is a delay in transport of >8 hours, refrigerate specimen, and send specimen refrigerated.

Additional Information:

1. Draw time is only a recommendation. Specific circumstances related to an individual patient, eg, renal function, hepatic function, concurrent medications, signs or symptoms of toxicity, and/or therapeutic response may necessitate individualization of drawing schedules.
2. Date and time of last dose, date and time of draw, and plasma are required.

Specimen Transport Temperature

Refrigerated

Specimen Stability

 

Specimen Type Temperature Time
Plasma or Serum Ambient 8 hours
  Refrigerated 2 days
  Frozen 2 months

 

Reference Values

 

Component Normal Range Critical Value
Vancomycin, Trough 10.0-20.0 ug/mL > 20.0 ug/mL
Vancomycin, Peak 25.0-40.0 ug/mL > 40.0 ug/mL
Vancomycin, Random 10.0-20.0 ug/mL  

 

Vancomycin Peak Goal Serum Levels
10.0-20.0 ug/mL Non-complicated infections
15.0-20.0 ug/mL

Complicated infections

(osteomyelitis, meningitis, eondocarditis, HAP due to S. aureus)

 

There is great disparity in vancomycin therapeutic ranges, especially with peak therapeutic ranges. Factors that might affect peak therapeutic ranges include dosage regimen and timing of specimen collection. Vancomycin levels in renal dialysis patients, burn patients, and intravenous drug abusers should be closely monitored.

 

Peak ranges: Specimens from adult volunteers drawn 2 hours after the completion of a 60 minute infusion of vancomycin ranged from 18 µg/mL to 26 µg/mL (12.1-17.4 µmol/L). Specimens drawn 1 hour after the completion of a 60 minute vancomycin infusion ranged from 25 µg/mL to 40 µg/mL (16.8-26.8 µmol/L). Specimens drawn 30 minutes after the completion of a 60 minute infusion of vancomycin ranged from 30 µg/mL to 40 µg/mL (20.1-26.8 µmol/L).

 

Trough ranges: Specimens should be drawn just before the next dose.

The physician must determine the appropriate therapeutic range for each patient.

Day(s) Test Set Up

Monday through Sunday

Test Classification and CPT Coding

80202