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Therapeutic vancomycin blood levels should be between 30 and 40 mg/l (maximum 50 mg/l) one hour after the end of the infusion, the minimum level (short prior to the next administration) between 5 and 10 mg/l. The concentrations should normally be monitored twice or three times per week.
At least one steady state trough level should be drawn just before the fourth dose in patients on long-term vancomycin treatment. More than one trough level is unnecessary for courses < 5 days and for dosing that targets levels < 15 mg/L. Patients on long courses of vancomycin that target trough levels of 15-20 mg/L should have levels measured once weekly if they are hemodynamically stable.