FIG 4.

The dosing vancomycin in patients undergoing intermittent hemodialysis, to achieve vancomycin trough concentrations between 15 and 20 mg/liter, must include a loading dosage of ≈20 mg/kg (evidence level IIB [83]), as suggested by a study carried out to develop a vancomycin dose calculator (Vandecasteele et al. [32]) and by several observational studies (Lin et al. [57], Rymarz et al. [58], and Jeremiah et al. [59]) (data expressed as mean ± SD). Thereafter, using pharmacokinetics data from 41 patients (32), the estimated doses for different intervals to the next hemodialysis may be 15, 25, and 35 mg/kg for 1-day, 2-day, and 3-day elapse times, respectively.