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Pharmacology: Pharmacokinetics: Absorption and Distribution: In subjects with normal renal function, multiple intravenous dosing of 1 g of Vancomycin (15 mg/kg) infused over 60 minutes produces mean plasma concentrations of approximately 63 mg/L immediately after the completion of infusion and mean plasma concentrations of approximately 23 mg/L 2 hours after infusion. Multiple dosing of 500 mg infused over 30 minutes produces a mean plasma concentrations of about 49 mg/L at the completion of infusion, mean plasma concentrations of about 19 mg/L 2 hours after infusion, and mean plasma concentrations of about 10 mg/L 6 hours after infusion. The plasma concentrations during multiple dosing are similar to those after a single dose.
Metabolism and Elimination: The mean elimination half-life of Vancomycin from the plasma is 4-hours in patients with normal renal function. About 75% of an administered dose of Vancomycin is excreted in urine by glomerular filtration in the first 24 hours.
Mean plasma clearance is about 0.058 L/kg/h and mean renal clearance is about 0.048 L/kg/h. Renal vancomycin clearance is fairly constant and accounts for 70% to 80% of vancomycin elimination. The volume of distribution ranges from 0.39 to 0.97 L/kg. There is no apparent metabolism of the drug. Vancomycin is 55% protein bound as measured by ultrafiltration at vancomycin serum levels of 10 to 100 mg/L.
After IV administration of Vancomycin, inhibitory concentrations are present in pleural, pericardial, ascetic, atrial appendage tissue and synovial fluid, as well as urine and peritoneal fluid.
Vancomycin does not readily penetrate the cerebrospinal fluid unless the meninges are inflamed.
