Vancomycin IV - Renal Dosing

In renally impaired patients, the initial dosing interval should be individualized based on specific patient and disease-state characteristics, serum concentration goals, site of infection, weight, age, and degree and stability of renal impairment (acute versus chronic). The below recommendations are intended as a guide, until serum vancomycin concentration data is available to further assist with dosing.

CrCl > 60 ml/min

No dose adjustment necessary

CrCl 41-60 ml/min

10-15 mg/kg IV every 12-24 hr

CrCl 21-40 ml/min

10 mg/kg IV every 24 hr

CrCl 10-20 ml/min

10 mg/kg IV every 24-48 hr

CrCl < 10 ml/min

10-15 mg/kg IV x1 then redose according to levels

15-25 mg/kg IV load x1 followed by 500 mg to 1 gm Post each HD session

10-15 mg/kg IV every 24 hr