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Test Code LAB39 Vancomycin, Trough

Useful For

Antimicrobial drug monitoring

Methodology

Kinetic Interaction of Microparticles in Solution (KIMS)

Performing Laboratory

Bozeman Health Laboratory Services

Specimen Requirements

Specimen Type: Serum (no gel)
Container/Tube: Red top w/out gel
Specimen Volume: 1 mL
Specimen Minimum Volume: 0.5 mL

Collection Instructions:

  1. Date and time of last dose, date and time of draw, and plasma are required.
  2. Specimen for a peak level should be drawn 30 to 60 minutes after administration of dose.
  3. Specimen for a trough level should be drawn immediately prior to next dose.

Specimen Rejection: Tubes containing separating gel will be rejected.

Specimen Transport Temperature

Ambient<48 hours/Refrigerated>48 hours

Specimen Stability

 

Specimen Type Temperature Time
Serum Ambient 48 hours
  Refrigerated 14 days
  Frozen 1 year

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  

 

Trough levels correlate better with efficacy than peak levels, with target trough levels of 10.0 to 20.0 mcg/mL, depending on the type of infection.

Additional Information

  • 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. The physician must determine the appropriate therapeutic range for each patient.
  • 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.
  • Trough levels are typically obtained before or after the 4th dose of the drug and then monitored at least once weekly.

Day(s) Test Set Up

Monday through Sunday

Test Classification and CPT Coding

80202