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Vancomycin challenge
1 microgram is .001 mg. Advised to do ID at .1microgram/ml in controlled study
Patient____________________________________________ Date:________
Time procedure started:____________________ Time patient discharged:__________
Use Vancomycin 50 mg/ml by adding 10 ml diluting solution to 500 mg dose. If this is
not the concentration provided, see Dr. Wallace.
Take 1 cc of 50 mg/ml and add 9 cc saline or water as used for diluting= 5 mg/ml
Take 1 cc of 5 mg/ml and add 9 cc saline or water as used for diluting= .5 mg/ml
Take 1 cc of .5 mg/ml and add 9 cc saline or water as used for diluting= .05 mg/ml
Take 1 cc of .05 mg/ml and add 9 cc saline or water as used for diluting= .005 mg/ml
Take 1 cc of .005 mg/ml and add 9 cc saline or water as used for diluting= .0005 mg/ml
Take 1 cc of .0005 mg/ml and add 4 cc saline or water as used for diluting= .0001 mg/ml
BP:______ Pulse: _____ Resp:_____ PFT’s done __________ Time record:_______
Time placed on patient ______________ Time Read: _________________
Do prick using .005 mg/ml mm induration__________ mm erythema _________
Do Prick using saline:
mm induration__________ mm erythema _________
Do Prick using Histamine: mm induration__________ mm erythema _________
-----------------------------------------------------------------------------------------------------BP:______ Pulse: _____ Resp:_____ PFT’s done __________ Time record:_______
Time placed on patient___________________ Time read: _________________
Do ID using .0001 mg/ml : mm induration__________ mm erythema _________
Do ID using saline: mm induration__________ mm erythema _________
Do ID using Histamine: mm induration__________ mm erythema _________
-------------------------------------------------------------------------------------------------BP:______ Pulse: _____ Resp:_____ PFT’s done __________ Time record:_______
Time placed on patient___________________ Time read: _________________
Do ID using .0005 mg/ml: mm induration__________ mm erythema _________
-----------------------------------------------------------------------------------------------------------BP:______ Pulse: _____ Resp:_____ PFT’s done __________ Time record:_______
Time Administered:
Take 1 cc of the 5 mg/ml IV concentration = 5 mg and give to patient orally and wait 20
minutes
-----------------------------------------------------------------------------------------------------------BP:______ Pulse: _____ Resp:_____ PFT’s done __________ Time record:_______
Time Administered:
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Take 1 cc of the 50 mg/ml = 50 mg IV solution and give orally wait 30 minutes
BP:______ Pulse: _____ Resp:_____ PFT’s done __________ Time record:_______
Give Vancomycin 125 mg oral tablet and wait 1 ½ hours
BP:______ Pulse: _____ Resp:_____ PFT’s done __________ Time record:_______
Pt is then to continue with Vancomycin 125 mg bid for 5 days
Comments:
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11/20/03