ABSTRACT
This chapter seeks to provide an overview of clinically useful information regarding the pharmacokinetics, clinical uses, and safety profile of vancomycin. Vancomycin exhibits poor oral bioavailability. Following oral administration, only trace amounts of vancomycin have been detected in the urine of patients with normal renal function. Vancomycin is readily absorbed from the peritoneal cavity in the absence of peritoneal inflammation, although absorption may be increased in the presence of peritonitis. Cerebrospinal fluid vancomycin concentrations following intravenous administration have generally been low in the absence of cerebrospinal fluid inflammation. Vancomycin cerebrospinal fluid penetration following intravenous administration may be enhanced in the presence of inflammation. Various vancomycin dosage guidelines for adults have been published to address the problem of interpatient pharmacokinetic variability and the changes in dosing required for various disease states. Predictive algorithms or nomograms attempt to define the appropriate initial dose of vancomycin before serum concentrations are available.
