Vancomycin Dosing Calculator
Co-developed by Matthew Girgis - ID PharmD trained in Boston, currently
fighting drug resistant bugs in Toronto, Canada.
Select method of dosing
Calculate an empiric regimen
Two levels at STEADY STATE
Two levels after the FIRST dose
Two levels -time difference (hrs)-Quick method
AUC Target:
400
450
500
550
600
0-24
Multi-calc: Empirically
derived or based on levels
Patient :
Location :
Age :
Sex :
Male
Female
Serum Creatinine :
mg/dL
umol/L
:
Inches
Centimeters
Weight :
Kilograms
Pounds
Levels (if available) - Select
option above first
Show/Hide Levels
: Number hours post dose : Trough level (2nd) obtained : Number hours post dose : Current dose being given : Current dosing interval :
Quick Version (only):First level
(peak) : 2nd level : Time difference
(hours) :
Empiric only
Ignore if levels available. Background information Elimination rate
constant:
Ke= 0.00083 x CRCL + 0.0044
Ke =Vanco CL/Vd
Bauer Method
Volume of Distribution: Select Vd :
0.2
0.25
0.3
0.35
0.4
0.45
0.5
0.55
0.6
0.65
0.7
0.75
0.8
0.85
0.9
0.95
L/kg - Normal = 0.65Modifications to the Vd based on body weight :
Always use Actual (total) weight for vanco dosing
Use Adjusted Body Weight for patients more than 20% over IBW
Amputations (Optional Field)
None
BKA - below the knee amputation
Bilateral BKA
Entire leg amputated
Both legs amputated
foot amputated
Arm amputated
Forearm/hand amputated
(optional)
Addition data required for further analysis.
Desired Peak :
Desired Trough :
Infusion time (ti) :
0.25 (15 min)
0.5 hours
1 hour
1.5
2.0
2.5
3.0
3.5
4.0
Info
AUC guided recommendations will appear on the results
page ]
Process form entries
References
here
Bauer LA. The Aminoglycoside Antibiotics. In Bauer LA, ed. Applied
Clinical Pharmacokinetics. 2nd ed. New York, NY: McGraw Hill Medical;
2008:97-206.Bauer LA. Vancomycin. In Bauer LA, ed. Applied Clinical
Pharmacokinetics. 2nd ed. New York, NY: McGraw Hill Medical; 2008:207-298.Burton ME , Shaw LM, Schentag JJ, Evans WE. Applied Pharmacokinetics &
Pharmacodynamics: Principles of Therapeutic Drug Monitoring. 4th ed.
Philadelphia: Lippincott Williams & Wilkins; 2006.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.Murphy JE. Aminoglycosides. In: Murphy JE, ed. Clinical Pharmacokinetics, 4th
ed. Bethesda, MD: American Society of Health-System Pharmacists, 2008:27-60.Winter ME. Basic clinical pharmacokinetics. 5th ed. Baltimore: Lippincott
Williams and Wilkins; 2010.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 ]
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]
Quotes : [Largest study so far....total of
3678 patients]Regarding Salazar equation : This equation,
however, was not consistently shown in studies to be a
superior predictor of renal function. It is not widely used in
clinical practice and has not been validated in
pharmacokinetic studies. In addition, the Salazar-Corcoran
equation is not recognized by the National Kidney Foundation.Regarding CG -LBW equation : Our findings do
not support those conclusions and are different from a recent
investigation of Clcr in 54 morbidly obese patients that found
that adjusting an obese patient’s weight to a fat-free weight
or lean body weight predicted a Clcr calculated with the C-G
equation without bias. Notably,
our study included 2065 obese or morbidly obese patients, far
more than other published studies. Conclusions : An unbiased C-G Clcr can be
calculated using actual body weight in underweight patients
and ideal body weight in patients of normal weight. Using
ABW0.4 for overweight, obese, and morbidly obese patients
appears to be the least biased and most accurate method for
calculating their C-G Clcr. Rounding Scr in patients with low
Scr did not improve accuracy or bias of the Clcr calculations.
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