Dialysis Adding Vancomycin to dialysate bag (1919)

Key points below

What supplies are needed?

10 mL, 3 mL, or 1 mL syringes
Medicine vial 
21-gauge needles (2 per dialysate bag)
Sterile water vials Dialysate bag
Alcohol wipes
Sharps container

How is it done? 

Get ready:
1. Prepare the room: Close the door and remove pets.  Turn off all fans, air conditioners, and heaters. 
2. Check the medicine and sterile water vials for the expiration date. Do not use if expired.
3. Open all bags and put on a clean work area. 
4. Put on mask.  All persons in the room should wear a mask.
5. Scrub hands for 1 minute. 
6.   Remove all caps from medicine and sterile water vials.  Place an alcohol wipe over each vial port (top of vial).  Use a new alcohol wipe for each port.
7. Open 10 mL syringe and 21-gauge needle and carefully connect them together.  Draw up 10 mL of air into the syringe.
8. Remove alcohol wipe from the sterile water and pierce the vial with the needle.  Push in the 10 mL of air.  Then draw up the correct amount of sterile water.  Check the antibiotic mixing chart.
9. Change needle to a new 21-gauge needle.  Put old needle in the sharps container.
10. Remove alcohol wipe from the medicine vial and slowly push in the sterile water.  If you meet resistance, let some air from the medicine vial into the syringe.  This will help to equalize the pressure in the vial.  Remove syringe and place in the sharps container. 
11. Rotate the vial to mix the antibiotic powder with the sterile water.  Wait for the solution to become clear.  There should not be any powder left in the vial.
12. Using a new syringe and 21-gauge needle, draw up the correct amount from the antibiotic chart (see separate sheet).
13. Change needle to a new 21-gauge needle.  Place old needle in your sharps container.
14. Clean dialysate bag medicine port with an alcohol wipe.
15. Carefully inject the medicine from the syringe into the dialysate bag medicine port.  Make sure the side wall of the medicine port is not pierced.
16. Repeat steps 6 through 15 for each dialysate bag.
17. Mix well by shaking each dialysate bag.
18. Put all needles into a sharps container.  Keep out of reach of children.

Follow-up care

Remember to reorder supplies through your supply company.  Be sure to order before you run out.


Call your child’s doctor, nurse, or clinic if you have any questions or concerns or if your child has:

  • Cloudy return of dialysate fluid, fever, or stomach pain.
  • Special health care needs that were not covered by this information.