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About Nigel Simmons
Expertise
I am happy to answer general questions on medicines and hospital care. If possible, please use approved / chemical names rather than brands which are not internationally recognised. Like all health professionals I am bound by a duty of care which prevents me giving detailed information about medication or treatment of people other than the questioner. I will endeavour to help wherever possible or point towards more appropriate advice. If however your question crosses too far into patient confidentiality, I hope you will understand why I cannot answer your question. Consider.. would you want me to discuss your care with a friend or relative without your knowledge?

Experience
Registered as a UK pharmacist in 1982 and have worked in a number of hospital and health management posts around the UK. Formerly Chief Pharmacist for a 440 bed general hospital in Cambridgeshire. Past/Present clients Previously Sysop on CompuServe UK Professionals forum.

You are here: Experts > Health/Fitness > Pharmacology > Pharmacy > IV Vancomycin

Topic: Pharmacy

Expert: Nigel Simmons
Date: 5/8/2008
Subject: IV Vancomycin

Question
I have been told Vancomycin burns as it is delivered via IV is this true? If so how badly?

Answer
Heather

The following is an extract from the UK clinical data sheet for vancomycin gives a clear explanation of the risks:

"Precautions

Vancomycin is very irritating to tissue and causes injection site necrosis if injected intramuscularly. Pain and thrombophlebitis occur in many patients receiving vancomycin and are occasionally severe. The frequency and severity of thrombophlebitis can be minimised if the drug is administered as a dilute solution (2.5-5 mg/ml) of Dextrose 5% or Normal Saline 0.9% solution and if the sites of injection are changed regularly."

Strictly speaking it does not burn, in a heat sense but the irritation will be very painful and the damage would be similar to a burn.

Ideally vancomycin should be given through a wide bore cannula into a large well flowing blood vessel. Idealy a "cut-down" to a major vessel such as in the neck would be preferable, but if a peripheral vein is used, then the dilution could be increased or the rate of administration slowed if the pain is too severe. Whatever site is used, it and the track of the vein should be checked regularly for signs of damage.

I hope this helps.

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