# AI指示用50mL D5W稀释1.5g静脉注射万古霉素，忽略浓度限制导致静脉炎风险

- **ID:** `medical/iv-antibiotic-dilution-error`
- **领域:** medical
- **类别:** data_error
- **错误码:** `IV-DILUTION-007`
- **验证级别:** ai_generated
- **修复率:** 90%

## 根因

万古霉素浓度在外周静脉给药时不应超过5 mg/mL；1.5g溶于50mL产生30 mg/mL，导致高渗透压和严重静脉炎；正确稀释至少需要300mL。

## 版本兼容性

| 版本 | 状态 | 引入 | 弃用 |
|------|------|------|------|
| vancomycin 1.5g vial | active | — | — |
| D5W 250mL bag | active | — | — |
| ISMP guidelines 2023 | active | — | — |

## 解决方案

1. ```
   Dilute 1.5g vancomycin in 300mL NS or D5W to achieve 5 mg/mL; use `python -c "print(f'Required volume: {1500/5} mL')"`
   ```
2. ```
   If fluid restriction needed, consider central line with concentration up to 10 mg/mL (150mL); document in EHR with pump rate calculation
   ```
3. ```
   Use premixed vancomycin bags (1g/200mL or 1.5g/300mL) from pharmacy to eliminate dilution errors
   ```

## 无效尝试

- **** — Central line reduces phlebitis risk but does not eliminate need for proper dilution; concentrated solution still causes precipitation or red man syndrome (70% 失败率)
- **** — Slow infusion does not reduce osmolarity damage; phlebitis occurs due to high concentration regardless of rate (90% 失败率)
- **** — Volume still insufficient (1.5g/100mL = 15 mg/mL, 3x limit); NS vs D5W does not change concentration requirement (80% 失败率)