Table 1.

Suggestions for vancomycin dosing during RRT

Modality	Recommendation	Comments
Thrice weekly intermittent hemodialysis – low flux membrane	Standard LD (20–25 mg/kg) based on actual body weight MD: Approximately 15–20 mg/kg qweek	Follow trough levels, especially with serious infections
Thrice weekly intermittent hemodialysis – high flux membrane	Standard LD as above MD: 10 mg/kg in last hour of each dialysis	Add an additional 250 mg to end of week MD Follow trough levels
Short daily dialysis – high flux membrane	Standard LD as above MD: 10 mg/kg after every other dialysis	Validated for MIC ≤1 mg/L; above that, use alternative agent
Continuous RRT	Standard LD as above MD: Consider 500–750 mg/q12 hour or 15–20 mg/kg when random level at desired trough	Consider residual renal function Follow trough level

LD, loading dose; MD, maintenance dose; RRT, renal replacement therapy.