Name of the Procedure:

Injection, vancomycin HCl, 500 mg (HCPCS: J3370)

Common Name(s): Vancomycin Injection, Antibiotic Infusion Technical/Medical Term: Parenteral Administration of Vancomycin Hydrochloride

Summary

Vancomycin is a powerful antibiotic used to treat severe bacterial infections. This procedure involves the injection of 500 mg of vancomycin hydrochloride directly into the bloodstream, typically through an intravenous (IV) line.

Purpose

Vancomycin injection is designed to combat serious bacterial infections, especially those that are resistant to other antibiotics. It is primarily used to treat infections like methicillin-resistant Staphylococcus aureus (MRSA), sepsis, and certain types of meningitis. The goals of the procedure are to effectively eliminate the bacterial infection, reduce symptoms, and prevent the spread of the infection within the body.

Indications

• Severe, life-threatening bacterial infections
• Infections caused by resistant bacteria like MRSA
• Specific criteria for patients who have not responded to other antibiotics

Preparation

• No specific fasting requirement, but the treating physician might have additional instructions.
• Pre-procedure assessments may include blood tests to evaluate kidney function, complete blood counts (CBC), and bacterial cultures to confirm the need for vancomycin.
• Any current medications must be reviewed to avoid potential drug interactions.

Procedure Description

1. An IV line is inserted into a vein, usually in the arm.
2. Vancomycin HCl, 500 mg, is prepared under sterile conditions.
3. The drug is administered slowly over at least 60 minutes to reduce the risk of side effects.
   • Equipment: IV bags, infusion pump, sterile gloves, antiseptic wipes.
   • No sedation or anesthesia is usually required.

Duration

The infusion typically takes around 60 to 90 minutes.

Setting

The procedure is performed in a healthcare setting such as a hospital, outpatient clinic, or specialized infusion center.

Personnel

• Registered Nurse (RN)
• Pharmacist (for drug preparation)
• Physician or Infectious Disease Specialist (for oversight and assessment)

Risks and Complications

• Common: Red man syndrome (flushing, rash, itching), pain at the injection site
• Rare: Allergic reactions, kidney damage, hearing loss
• Complications are usually managed with adjustments in infusion rate, antihistamines, or discontinuation of the drug.

Benefits

• Effective treatment for severe bacterial infections
• Rapid onset of drug action
• Expected improvement within a few days after starting treatment

Recovery

• Regular monitoring of kidney function and hearing
• Follow-up blood tests to ensure the infection is clearing
• Patients may be advised to stay hydrated
• Minimal activity restrictions; normal daily activities can typically be resumed after the infusion

Alternatives

• Other antibiotics like linezolid, daptomycin, or trimethoprim-sulfamethoxazole
• Pros: Oral alternatives available, different side effect profiles
• Cons: May not be as effective for certain resistant infections

Patient Experience

• Patients may feel a mild discomfort when the IV is inserted.
• Tingling or warming sensation during the infusion is possible.
• Most side effects are mild and manageable, with comfort measures such as slower infusion rates and antihistamines providing relief.