Peak & Trough Vancomycin is a glycopeptide antibiotic. It is a time dependent killer. The level has to stay above a minimum concentration for a length of time for the medication to be effective. Thus, Vancomycin doses should not be held while waiting for a trough level. Vancomycin peak levels are not routinely monitored, however if ordered by the MD, the peak should be drawn 1 hour after medication dose is complete. Exception – if the ordered dose of Vancomycin is 2 grams or more then obtain the peak 2 hours after the infusion is complete.
Peak & Trough (cont) Collect trough immediately prior to dose Blood must NOT be drawn from the line it was infusing in Blood is drawn from a different port, it is NOT drawn from the port it was infused in Do not draw a trough level while Vancomycin is infusing Do not wait for trough results before hanging antibiotic unless a specific order to wait for result is ordered by MD Administer antibiotic at prescribed rate so levels are accurate
Peak & Trough (continued)Gentamicin Gentamicin is an aminoglycoside antibiotic. It works differently. It is a concentration dependent killer. This means the higher the peak concentration, the larger the kill of microorganisms. Gentamicin can kill microorganisms after the concentration has decreased (this is called a post-antibiotic effect). Patients on Gentamicin are monitored to ensure that levels are adequate for therapy and to detect elevated levels that may be associated with a greater risk of ototoxicity and nephrotoxicity.
Peak & Trough (continued) Blood must NOT be drawn from the line it was infusing in Blood is drawn from a different port, it is NOT drawn from the port it was infused in Do not wait for trough results before hanging antibiotic unless specific order to wait for result is ordered by MD Administer antibiotic at prescribed rate so that peak levels will be accurate If dose is received to infuse over 30 minutes, collect peak 30 minutes after dose completion EXCEPTION – If the dose is ordered to infuse over 60 minutes, then the peak is drawn 15 minutes after the infusion is complete