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About

Vancomycin requires precise dosing to balance efficacy against the risk of nephrotoxicity and ototoxicity. This pharmacokinetic tool estimates the initial maintenance dose by calculating Creatinine Clearance (CrCl) using the Cockcroft-Gault equation. It incorporates patient-specific parameters such as weight, age, and serum creatinine to determine the Elimination Rate Constant (ke) and Volume of Distribution (Vd). The calculator targets a trough concentration of 10-20 mcg/mL, essential for treating serious MRSA infections, and alerts clinicians to renal impairment requiring interval adjustments.

pharmacokinetics dosing vancomycin medical calculator

Formulas

The calculator uses the Cockcroft-Gault equation for clearance and first-order kinetics for dosing:

1. Creatinine Clearance (Male):

(140 Age) × Weight72 × SCr

2. Elimination Rate Constant (ke):

ke 0.00083 × CrCl + 0.0044

Females multiply CrCl by 0.85.

Reference Data

CrCl (mL/min)Typical Interval (τ)Dosing Consideration
> 90q8h or q12hStandard renal function. Higher frequency may be needed for rapid clearance.
60 - 90q12hStandard maintenance interval. Monitor troughs.
40 - 59q12h or q24hModerate impairment. Consider extending interval to 24 hours.
20 - 39q24hSignificant impairment. Daily dosing usually sufficient.
< 20Pulse / Level-basedSevere failure. Dose by levels (check random levels).
DialysisPost-HDAdminister loading dose, then maintenance after dialysis sessions.
High BMIWeight-based capUse Adjusted Body Weight if >120% IBW to prevent overdose.
ElderlyConservativeAssume lower muscle mass; SCr may overestimate function.

Frequently Asked Questions

The tool defaults to Actual Body Weight (ABW) for the Cockcroft-Gault formula unless the patient is significantly obese, where clinical judgment often suggests Adjusted Body Weight. The Volume of Distribution (Vd) is calculated using ABW.
The standard therapeutic range for most serious infections (pneumonia, osteomyelitis) is 15-20 mcg/mL. For less severe infections (skin/soft tissue), 10-15 mcg/mL may be sufficient.
If the calculated CrCl is below 30 mL/min, the tool triggers a warning suggesting "Pulse Dosing" or "Pharmacy Consult" rather than a fixed standard interval.