Oral vancomycin desensitisation to treat Clostridium difficile infection in a vancomycin allergic patient

Table 1 Oral vancomycin desensitisation protocol

Fraction of dose	Dose given (mg)	Cumulative dose (mg)	Volume given (ml)
Using Solution A, 0.01 mg/ml
1/10,000	0.025	0.025	2.5
1/5,000	0.05	0.075	5
1/2,500	0.1	0.175	10
1/1,250	0.2	0.375	20
Using Solution B, 1 mg/ml
1/625	0.4	0.775	0.4
1/312	0.8	1.575	0.8
1/160	1.5	3.075	1.5
1/80	3.0	6.075	3
1/40	6.0	12.075	6
Using Solution C, 5 mg/ml
1/20	12.5	24.575	2.5
1/10	25	49.575	5
1/5	50	99.575	10
1/ 2.5	100	199.575	20
	150	349.575	30
1/ 1.25	200	549.575	40

Make up 1 mg/ml solution (500 mg vancomycin in 500 mls saline or other diluent). This is Solution B.
Make up 0.01 mg/ml solution (Take 1 ml of solution B, dilute it in 100 mls saline.) This is Solution A.
Make up 5 mg/ml solution (500 mg Vancomycin in 100 mls saline or other diluent). This is Solution C.

ISSN: 1939-4551