Vancomycin IV - Renal Dosing

In the setting of rapidly improving or worsening renal function, calculations of CrCl are inaccurate. Dosing should be based on estimated renal function instead.

If improving renal function, actual CrCl is likely higher than calculated CrCl.

If worsening renal function, actual CrCl is likely lower than calculated CrCl.

Consult pharmacy for dosing recommendations

15-25mg/kg load then 5-10mg/kg IV after each HD

Monitoring required

Consult pharmacy for dosing recommendations

15mg/kg load then 10mg/kg IV q24h

Monitoring required