Staphylcoccus Aureus(MIC=1)
- AUC;MIC> 400
- trough 15 mcg/mL
- normal renal function
  - 15-20 mg/kg Q8-12H
- Renal dysfunction
  - Age < 40 and Scr is <1.4, interval= Q8H
  - Age 40- 65 and has a Scr <1.4, interval = Q12h
  - Age > 65 or Scr is >1.4 (regardless of age), interval = Q24h
  - CVVH Dialysis, 10-15 mg/kg Q24H
Adjusting Vanco Levels
- can adjust proportionally
- Current dose/Cmin(actual)=x(new dose)/Cmin(desired)
Dosing based on Kinetics
- Elimination rate constant (kel): Vancomycin kel = (0.00083 x CrCl) + 0.0044
- t1/2 = 0.693/kel
- Calculation of trough concentration at steady state (Cpminss)
  - Cpminss = (Cpmaxss)(e-Kel (Τ-t’))
- MD = maintenance dose
  - MD = (Cpmax)(Vd)(t')(Kel) x (1-e^(-KelΤ))
    (1-e^(-Kelt’))

Vancomycin Dosing