GuidelinesOther guideline

Renally Adjusted Dosing of Vancomycin in Adults

The current recommended empiric antibiotic choices and empiric durations for suspected bacterial infections at CHBAH, based on consensus agreement between Infectious Diseases (ID), Microbiology and specialties after review of our 2018 antibiogram data, is as follows until directed therapy is possible.

Vancomycin

Loading dose for severe infections eg. Bacteremias is 25-30mg/kg stat
Maintenance doses are based on 15-20mg/kg (unless inadequate trough levels achieved)
Dosing interval and measurement of trough concentrations are based on renal function:

eGFR (ml/min)	Dosing interval (hours)	Measurement of trough conc
>80	12	before 4th dose
40-79	24	before 4th dose
25-40	48	before 3rd dose
<25/HD/CAPD	when trough level <15	after 3 days

Source: Gauteng Provincial AMSC Antibiotic Prescription Chart and South African Medicines Formulary, 11th Edition 2014

Drugs mentioned

Vancomycin