Test Catalog

Test Id : VANRA

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Vancomycin, Random, Serum

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Monitoring adequacy of drug concentration during vancomycin therapy whenever a specimen is submitted or collected without collection timing information

Method Name
A short description of the method used to perform the test

Immunoassay

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Vancomycin, Random, S

Aliases
Lists additional common names for a test, as an aid in searching

Antibiotic Assay

Antimicrobial Assay

Vancocin (Vancomycin Hydrochloride)

Specimen Type
Describes the specimen type validated for testing

Serum Red

Ordering Guidance

In addition to this random assay, both peak level and trough level testing are available.

1. Serum for a peak level should be drawn 1 hour after completion of dose; order VANPA / Vancomycin, Peak, Serum.

2. Serum for a trough level should be drawn no more than 30 minutes prior to next dose; order VANTA / Vancomycin, Trough, Serum.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Collection Container/Tube: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions: Centrifuge and aliquot serum within 2 hours of collection.

Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

0.25 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Red Refrigerated (preferred) 14 days
Frozen 365 days
Ambient 48 hours

Useful For
Suggests clinical disorders or settings where the test may be helpful

Monitoring adequacy of drug concentration during vancomycin therapy whenever a specimen is submitted or collected without collection timing information

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Vancomycin is an antibiotic used to treat infections caused by gram-positive organisms that are resistant to beta-lactam antibiotics, such as methicillin-resistant staphylococci (MRSA), Streptococcus viridans group, penicillin/cephalosporin-resistant Streptococcus pneumoniae, and penicillin/ampicillin-resistant Enterococcus species. The oral formulation, which is not absorbed, is used in the treatment of pseudomembranous colitis caused by Clostridium difficile. Vancomycin is also used when patients are intolerant or allergic to beta-lactam antibiotics.

 

Vancomycin has been associated with nephrotoxicity and ototoxicity, although it appears that many of these reports reflected impurities in early formulations. Monitoring of vancomycin-related nephrotoxicity is recommended only for patients with reduced renal function, those receiving aggressive or prolonged vancomycin regimens, or those at high risk including patients comedicated with other nephrotoxic agents.

 

Trough concentrations are recommended for therapeutic monitoring of vancomycin, preferably acquired at steady state (just before fourth dose). To avoid development of resistance, vancomycin trough levels should remain above 10.0 mcg/mL. Complicated infections require higher target levels, typically 15.0 to 20.0 mcg/mL. Peak concentrations do not correlate well to efficacy or nephrotoxicity, but may be useful for pharmacokinetic studies or for select patients.

 

Random levels may be ordered when attempting to determine when to dose vancomycin in patients with renal impairment or those undergoing dialysis.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

VANCOMYCIN, TROUGH

Therapeutic: 10.0-20.0 mcg/mL

 

VANCOMYCIN, PEAK

Therapeutic: 20.0-45.0 mcg/mL

Interpretation
Provides information to assist in interpretation of the test results

Trough levels correlate better with efficacy than peak levels, with target trough levels of 10.0 and 20.0 mcg/mL, depending on the type of infection.

 

Peak levels are not recommended for monitoring, except in select circumstances such as when performing pharmacokinetic analyses (eg, area under the curve: AUC determinations). Typical peak levels are between 20.0 and 45.0 mcg/mL.

 

These levels are consistent with Mayo Clinic Antimicrobial Therapy Guidelines.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

As with any assay employing mouse antibodies, the possibility exists for interference by human antimouse antibodies (HAMA) in the sample, which could cause falsely lowered results.

 

Unspecific binding of heterophilic antibodies from the sample to glucose-6-phosphate dehydrogenase of the reagent may lead to falsely lower test results in very rare cases (<10[-6]).

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Rybak M, Lomaestro B, Rotschafer JC, et al: Therapeutic drug monitoring of vancomycin in adult patients: A consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists. Am J Health Syst Pharm. 2009;66:82-98

2. Estes L, Wilson J: Mayo Clinic Antimicrobial Therapy Quick Guide. Mayo Clinic. 2005. Updated July 29, 2020

Method Description
Describes how the test is performed and provides a method-specific reference

The assay is based on the kinetic interaction of microparticles in solution (KIMS). Vancomycin antibody is covalently coupled to microparticles and the derivative is linked to a macromolecule. The kinetic interaction of microparticles in solutions is induced by binding of drug-conjugate to the antibody on the microparticles and is inhibited by the presence of vancomycin in the sample. A competitive reaction takes place between the drug conjugate and vancomycin in the sample. A competitive reaction takes place between the drug conjugate and vancomycin in the serum sample for binding to the vancomycin antibody on the microparticles. The resulting kinetic interaction of microparticles is indirectly proportional to the amount of drug present in the sample.(Package insert: Roche Vancomycin reagent, Roche Diagnostic Corp, Indianapolis, IN.  2016-09 Ver. 1)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 2 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

80202

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
VANRA Vancomycin, Random, S 20578-1
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
VANRA Vancomycin, Random, S 20578-1

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports