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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:
L/kg
Usual range:
Vanco: 0.65 - 0.9
Infusion time (ti):

#### 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.

(optional)

## 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: 1053â€“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]

## Trough Calculators

Allows the user to estimate the actual (extrapolated) trough based on the elimination rate constant and the number of hours the level was drawn before the next scheduled dose. A supratherapeutic level may be actually therapeutic if it was drawn just before the next dose. Trough drawn early? -Estimation Tool based on entered Kel
This new program can be used to determine when to administer the next dose of vancomycin after a supratherapeutic trough is obtained. An estimated elimination rate constant is generated from the creatinine clearance which is then used to determine the timing of the next dose based on the desired target trough concentration.
Vancomycin -Timing of next dose based on estimated Ke value

Use this program if the vancomcyin level is drawn early and you want to estimate the actual trough just before the next dose to determine if the current regimen is appropriate Vancomycin – Predicted Trough-Level drawn early

## Dosing by levels

Dosing by levels (Full) Dosing by levels – pharmacokinetics (quick) Non-Steady State kinetics

## Pharmacokinetics

Pharmacokinetics -Multiple Ke (Advanced version)Pharmacokinetic dosing -aminoglycosides/Vanco Original program

## Vancomycin – Single-level dosing

Vancomycin SINGLE Level-(dosing by levels) Original calc
If you would like to enter the time since the last dose was given, use this version. This new version may be especially useful if the trough was drawn late and thenext dose was delayed. Example: current regimen vanco 1 gram q12h. Trough wasdrawn 12.5 hours after the last dose.Vancomycin single-level – dose infused early or late

The GlobalRPh vancomycin single-level calculator uses the Vd recommended in Bauer’s text: 0.7 L/kg. Use the advanced version if you wish to manipulate this value.Vancomycin single level – Advanced version
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