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Vancomycin Dosing Calculator

Check out the new advanced version of this calculator that also has built-in levels. Initial dosing based on a target AUC is also available. Calculator >>

Patient-Specific Data

Patient:     Location:  
Age:     Sex    Serum Creatinine    
Height
:      Weight:

Clearance method
:
 

Drug Selection, Levels, and Drug-specific PK Parameters:

Select Drug: Desired Peak:   mcg/ml

Desired Trough:   mcg/ml

[AUC guided recommendations will appear on the results page]
Volume of distribution:led
   L/kg
Usual range:
Vanco: 0.65 - 0.9  
Infusion time (ti): led
 
 Additional Info

Select elimination rate constant (Ke) calculation method:

Background information
(VANCOMYCIN)
:  
Ke = 0.00083 x CRCL + 0.0044  Usual Vd reported: 0.9 L/kg. (0.7 - 0.9 L/kg)  Ref: 3,4,5
Clearance method: CL (L/hr) = CrCl (ml/min) x 0.06.  Ke =  Vanco CL/Vd. Usual Vd: 0.7L/kg. Ref: 6
Ke (hr-1) = [(0.695[(CrCl mL/min)/TBW kg] + 0.05)  x 0.06] / Vd factor ]   Usual Vd: 0.7L/kg.   Ref: 2

New option based on input from clinicians - general assumption, adjusted body weight may be used in the morbidly obese patients receiving vancomycin:   Historically actual or total is used in all cases.
Use Adjusted body weight     or   Use Actual (total) weight for vanco dosing.
 

Amputations (Optional Field)

(optional)

Process form entries





Cockcroft and Gault equation utilizing the ibw (Ideal body weight) to calculate an estimated creatinine clearance

Cockcroft and Gault equation:
CrCl = [(140 - age) x IBW] / (Scr x 72) (x 0.85 for females)
Note: if the ABW (actual body weight) is less than the IBW use the
actual body weight for calculating the CRCL.

Estimate Ideal body weight in (kg)
Males: IBW = 50 kg + 2.3 kg for each inch over 5 feet.
Females: IBW = 45.5 kg + 2.3 kg for each inch over 5 feet.

Salazar-Corcoran Equation

Estimating Creatinine Clearance (ml/min)    -   Units: Weight: kg      Height: meters.
For Men:
[137 - age] x [(0.285 x weight(kg)) + (12.1 x height(m)2)]  /  (51 x SCr)

For Women:
[146 - age] x [(0.287 x weight(kg)) + (9.74 x height(m)2)]  /  (60 x SCr)

Salazar DE, Corcoran GB: Predicting creatinine clearance and renal drug clearance in obese patients from estimated fat-free body mass. Am J Med 84: 1053–1060, 1988.

References


This latest version is based on a comprehensive review of the most recent pharmacokinetic textbooks. Some of the sources used are listed here
  1. Bauer LA. The Aminoglycoside Antibiotics. In Bauer LA, ed. Applied Clinical Pharmacokinetics. 2nd ed. New York, NY: McGraw Hill Medical; 2008:97-206.

  2. Bauer LA. Vancomycin. In Bauer LA, ed. Applied Clinical Pharmacokinetics. 2nd ed. New York, NY: McGraw Hill Medical; 2008:207-298.

  3. Burton ME, Shaw LM, Schentag JJ, Evans WE. Applied Pharmacokinetics & Pharmacodynamics: Principles of Therapeutic Drug Monitoring. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2006.

  4. DiPiro JT, Spruill WJ, Wade WE, Blouin RA, Pruemer JM. Concepts in Clinical Pharmacokinetics, (5th Edition) 2010. American Society of Health Systems Pharmacist, Bethesda, MD.

  5. Murphy JE. Aminoglycosides. In: Murphy JE, ed. Clinical Pharmacokinetics, 4th ed. Bethesda, MD: American Society of Health-System Pharmacists, 2008:27-60.

  6. Winter ME. Basic clinical pharmacokinetics. 5th ed. Baltimore: Lippincott Williams and Wilkins; 2010.

  7. Winter MA, Guhr KN, Berg GM. Impact of various body weights and serum creatinine concentrations on the bias and accuracy of the Cockcroft-Gault equation. Pharmacotherapy 2012; 32: 604-612 [PMID: 22576791 DOI: 10.1002/j.1875-9114.2012.01098.x]
  8. Rybak MJ, Le J, Lodise TP,Levine DP, Bradley JS, Liu C, et al. Therapeutic monitoring of vancomycin: A revised consensus guideline and review of 1the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society and the Society of Infectious Diseases Pharmacists. Accessed: May 2019. [Link]

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