An improved method of vancomycin administration to dialysis patients

Vancomycin is a nondialyzable antibiotic frequently used by patients on hemodialysis. Traditionally, a 1-gram dose is administered at the conclusion of dialysis. Recent rate-related side effects have prompted the manufacturer to revise the package insert suggesting a maximum infusion rate of 500 mg/h; necessitating a two-hour infusion post-dialysis. We evaluated the safety and efficacy of vancomycin administered during dialysis in nine chronic hemodialysis patients in an open crossover study. All patients received vancomycin during and post-dialysis in consecutive weeks. Therapeutic peak and trough serum concentrations were achieved in all patients. No adverse reactions occurred.