![]() ![]() Yes, this website will continue to be available for free. Will this vancomycin calculator remain free of charge? CVVHD: 10 to 15 mg/kg every 24 hours or 7.5 mg/kg every 12 hours. ![]() Blood samples should be collected to adjust maintenance dosing to a goal AUC/MIC between 400 to 600 mg*h/L. Continuous Renal Replacement Therapy (CRRT) 14Īn initial loading dose of 15 to 25 mg/kg is recommended followed by a maintenance dose based on the CRRT modality (see below). Blood samples may be collected before hybrid dialysis (pre-dialysis) or 1-2 hours after hybrid dialysis (post-dialysis) and should be used to adjust maintenance dosing to a goal AUC/MIC between 400 to 600 mg*h/L. Sustained Low Efficiency Dialysis (SLED) 12, 13Īn initial loading dose of 20 to 25 mg/kg is recommended followed by 15 mg/kg after the end of each hybrid hemodialysis session. Blood samples may be collected before dialysis (pre-dialysis) or 1-2 hours after dialysis (post-dialysis) and should be used to adjust maintenance dosing to a goal AUC/MIC between 400 to 600 mg*h/L. Intermittent Hemodialysis 12Īn initial loading dose of 25 mg/kg is recommended followed by 7.5 to 10 mg/kg after each hemodialysis session. The following are general considerations and recommendations for this patient population. For example, blood flow rate, filter type, hemodialysis frequency or downtime, effluent rate, and residual renal function are among several factors that influence a patient's vancomycin dosing needs. Vancomycin dosing in patients receiving renal replacement therapy is complex and usually requires expert clinical judgment in conjunction with assessment of unique patient-specific factors. The use of two drug concentrations allows for patient-specific estimations of all pharmacokinetic parameters using the Sawchuk-Zaske method.ĭosing Recommendations for Renal Replacement Therapy (RRT) These drug levels can either be obtained after the first dose is given (non-steady state) or once steady state is achieved (after the third dose is administered). The most optimal method of monitoring vancomycin therapy is to obtain two drug levels (such as a peak and trough concentration) during the same dosing interval. Once patient-specific values of Kel and Vd have been determined, traditional one-compartment pharmacokinetic equations are used to identify a dose and its associated peak, trough, and AUC/MIC values. Use patient-specific Kel and Vd for additional calculations Vd is the volume of distribution (in liters) dose is the vancomycin dose (in milligrams) T inf is the vancomycin infusion time (in hours) k is the elimination constant (Kel, in hr -1) C max is the true peak concentration C min is the true trough concentration (if at steady state) or is 0 (zero) if not at steady state 4.
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