Table 1 Protocol for Vancomycin administration in use in our department
CLINICAL PROTOCOL | |
|---|---|
STARTING LOADING DOSE: | |
if body weight < 65 Kg = 1000 mg | |
if body weight ≥ 65 Kg = 1500 mg | |
DAILY DOSE: | |
Creatinine clearance | Vancomycin daily dose |
>50 ml/min/1,73 m2 | 2000 mg |
50-20 ml/min/1,73 m2 | 1500 mg |
20-10 ml/min/1,73 m2 | 1000 mg |
<10 ml/min/1,73 m2 | 500 mg |
DOSE ADJUSTMENT AFTER VANCOMYCIN SERUM CONCENTRATION (VSC) MEASUREMENT: | |
VSC | Adjustment dose |
<15 mg/L | Increase infusion 500 mg/day |
15-25 mg/L | Do not change infusion |
25-30 mg/L | Riduce infusion 500 g/day |
>30 mg/L | Stop infusion for 6 h, than riduced dose |