Desired vancomycin trough is 10-20mg/L. Monitor renal function closely. See Vancomycin Dosing & Monitoring Guidelines.

Add vancomycin if MRSA suspected. Use linezolid if significant renal dysfunction or concomitant nephrotoxic therapy.

• previous (prior 12 months)/current MRSA colonization or infection

• recent antibiotic use

• recent hospitalization.