Serum Vancomycin Levels in Patients Receiving Enteral Vancomycin
Serum Vancomycin Levels in Patients Receiving Enteral Vancomycin
The study is based on the hypothesis that decreased creatinine clearance may be associated
 with detectable vancomycin levels in patients on enteral (oral / vancomycin enemas)
 vancomyicn for CDAD.

 The objective of the study is to see whether enteral vancomycin is absorbed through the
 inflamed GI mucosa in CDAD, and if it is absorbed, does it achieve measurable serum
 concentration.
Vancomycin is a large glycopeptide compound with a molecular weight of about 1450 Da. It is
 not appreciably absorbed orally and is eliminated primarily via the renal route. Enteral
 vancomycin therapy (oral/intracolonic ) is used inpatients with severe Clostridium difficile
 associated colitis who are unable to take oral metronidazole or have failed treatment with
 metronidazole. Oral vancomycin is not detectable in serum of normal persons, but
 concentrations below therapeutic range may be found in patients with colitis. There are a few
 case reports of serum concentrations within the therapeutic range after oral/intracolonic
 administration of vancomycin, in association with renal failure. The use of enteral
 vancomycin in our geriatric population with variable creatinine clearance prompted us to
 measure the serum vancomycin levels in these patients.
Inclusion Criteria:

 -  Patients on enteral vancomycin therapy

 Exclusion Criteria:

 -  Coadministration of intravenous vancomycin therapy,intravenousvancomycin
 administration in previous10 days.