Table 1.

Published criteria by the CDC for vancomycin use (1).

Vancomycin Use

Appropriate Serious infections caused by beta-lactam resistant gram-positive microorganisms Infections caused by gram-positive microorganism in patients allergic to beta-lactam antimicrobials Antibiotic-associated colitis that fails to respond to metronidazole therapy or is severe and potentially life-threatening Prophylaxis, as recommended by the American Heart Association, for endocarditis following certain procedures in high risk patients Surgical prophylaxis, with prosthesis implant, in institutions with high rates of infections caused by MRSA or methicillin-resistant Staphylococcus epidermidis Inappropriate Routine surgical prophylaxis other than in patients with a life threatening allergy to beta-lactam antibiotics Empiric antimicrobial therapy for a febrile neutropenic patient, unless strong evidence is present of an infection caused by gram-positive microorganisms and the prevalence of infections caused by MRSA in the hospital is substantial Treatment of a single blood culture for coagulase-negative Staphylococcus if other blood cultures collected simultaneously are negative Continued empiric use in patients whose cultures are negative for beta-lactam-resistant gram-positive microorganisms Systemic or local prophylaxis for infection or colonization of indwelling central or peripheral intravascular catheters Selective decontamination of the gastrointestinal tract Eradication of MRSA colonization Primary treatment of antibiotic-associated colitis Routine prophylaxis for very low-birthweight infants Topical application or irrigation of vancomycin solution Treatment (chosen for dosing convenience) of infections caused by beta-lactam-sensitive gram-positive microorganisms in patients with renal failure Routine prophylaxis for patients on continuous ambulatory peritoneal dialysis or hemodialysis

MRSA: methicillin resistant Staphylococcus aureus