Classification of antibiotics – the glycopeptides: answers

02 April 2025
Volume 7 · Issue 4

Abstract

An adult, weight 75 kg, is diagnosed with severe community-acquired pneumonia and prescribed vancomycin. A loading dose of 26 mg/kg (max 2 g) by intravenous infusion is given and a maintenance dose of 20 mg/kg is prescribed. A high vancomycin plasma concentration is obtained, and the maintenance dose is decreased by 10%.

QUESTION 1

An adult, weight 75 kg, is diagnosed with severe community-acquired pneumonia and prescribed vancomycin. A loading dose of 26 mg/kg (max 2 g) by intravenous infusion is given and a maintenance dose of 20 mg/kg is prescribed. A high vancomycin plasma concentration is obtained, and the maintenance dose is decreased by 10%.

  • 1a). What is the loading dose?
  • 1b). What is the initial prescribed maintenance dose?
  • 1c). What should the reduced maintenance dose be in response to the high serum vancomycin concentration?
  • a). 26 mg x 75 = 1950 mg = 1.95 g
  • b). 20 mg x 75 = 1500 mg = 1.5 g
  • c). 10% of 1500 mg = 150 mg. 1500–150 = 1350 mg = 1.35 g

QUESTION 2

A neonate aged 32 weeks, weight 1560 g, is diagnosed with bacterial meningitis and prescribed vancomycin. They are prescribed 15 mg/kg every 12 hours to be adjusted in response to serum plasma concentration. What is the initial prescribed dose?

  • 15 mg x 1.560 kg = 23.4 mg

QUESTION 3

An adult, weight 43 kg, is diagnosed with streptococcal endocarditis and prescribed teicoplanin. They are prescribed 12 mg/kg by intravenous infusion.

What is the initial prescribed dose?

  • 12 x 43 = 516 mg

QUESTION 4

A 1-month-old child, weight 7 kg, is diagnosed with cellulitis and prescribed teicoplanin. Initial loading dose is 16 mg/kg followed by 8 mg/kg maintenance dose.

  • 4a) What is the initial loading dose?
  • 4b) What is the maintenance dose?
  • a). 16 x 7 = 112 mg
  • b). 8 x 7 = 56 mg