Suggested Maintenance Dose

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TargetAUC₂₄ 400–600 · MIC 1.0
FreqDoseAUC₂₄PeakTrough
—

Doses rounded to 250 mg · Max infusion rate 1,000 mg/hr · = 3,500 mg absolute ceiling applied

Predicted Concentration–Time Curve

Awaiting patient input.

ASHP/IDSA 2020 targets AUC₂₄/MIC rather than trough concentration. Trough values are shown in the dose card for reference only and are not the primary monitoring parameter.

Methodology

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Creatinine clearanceCockcroft-Gault
(140 − age) × weight / (72 × SCr) [× 0.85 female]
Elimination rate kₑ — Matzke
kₑ = 0.00083 × CrCl + 0.0044
Volume of distribution
Vd = 0.70 L/kg × TBW (0.80 if critically ill)
IBW — Devine formula
IBW = 50 (male) / 45.5 (female) + 2.3 × (height_in − 60)
▾References (7)
  1. 1.Rybak MJ, Le J, Lodise TP, et al. Therapeutic monitoring of vancomycin for serious MRSA infections: a revised consensus guideline. Am J Health Syst Pharm. 2020;77(11):835–864.[Primary guideline — AUC24-guided dosing]
  2. 2.Matzke GR, McGory RW, Halstenson CE, Keane WF. Pharmacokinetics of vancomycin in patients with various degrees of renal function. Antimicrob Agents Chemother. 1984;25(4):433–437.[kₑ = 0.00083 × CrCl + 0.0044]
  3. 3.Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16(1):31–41.[CrCl formula used when BMI < 40]
  4. 4.Salazar DE, Corcoran GB. Predicting creatinine clearance and renal drug clearance in obese patients from estimated fat-free body mass. Am J Med. 1988;84(6):1053–1060.[CrCl formula used when BMI ≥ 40]
  5. 5.Devine BJ. Gentamicin therapy. Drug Intell Clin Pharm. 1974;8:650–655.[Ideal body weight formula]
  6. 6.Ambrose PJ, Winter ME. Vancomycin. In: Basic Clinical Pharmacokinetics, 4th ed. Lippincott Williams & Wilkins; 2004:451–476.[Single-level back-calculation (Ambrose-Winter)]
  7. 7.Wurtz R, Itokazu G, Rodvold K. Antimicrobial dosing in obese patients. Clin Infect Dis. 1997;25(1):112–118.[Limb-weight fraction estimates for amputation correction]

Kinetic Parameters

CrCl (Cockcroft-Gault)—
Elimination rate (kₑ)—
Volume of distribution (Vd)—
Clearance (CLᵥₐₙ꜀ₒ)—
Half-life (t½)—
IBW · AdjBW—
BMI—