Table 6.

Dosage recommendations for vancomycin in neonates^a.

Guide	Age (years) /Scr (μmol/L)	Dosage recommendations
Neonatal Formulary	PMA <29	20 mg/kg every 24 h
(2015)	PMA 30–33	20 mg/kg every 18 h
	PMA 34–37	20 mg/kg every 12 h
	PMA 38–44	15 mg/kg every 8 h
	PMA >45	10 mg/kg every 6 h
Red Book	Scr < 61.9	15 mg/kg every 12 h
(2015)	Scr 61.9–79.6	20 mg/kg every 24 h
	Scr 88.4–106.1	15 mg/kg every 24 h
	Scr 114.9–141.5	10 mg/kg every 24 h
	Scr> 141.5	15 mg/kg every 48 h
Pediatric Neonatal Dosage Handbook	GA ≤ 28 and Scr < 44.2	15 mg/kg every 12 h
(2015–2016)	Scr 44.2–61.9	20 mg/kg every 24 h
	Scr 70.7–97.3	15 mg/kg every 24 h
	Scr 97.3–123.8	10 mg/kgevery 24 h
	Scr> 123.8	15 mg/kgevery 48 h
	GA > 28 and Scr < 61.9	15 mg/kg every 12 h
	Scr 61.9–79.6	20 mg/kg every 24 h
	Scr 88.4–106.1	15 mg/kg every 24 h
	Scr 114.9–141.5	10 mg/kg every 24 h
	Scr 141.5	15 mg/kg every 48 h
	PNA < 7 and WT < 1200 g	15 mg/kg every 24 h
	WT 1200–2000 g	10–15 mg/kg every 12–18 h
	WT > 2000g	10–15 mg/kg every 8–12 h
	PNA ≥ 7 and WT < 1200 g	15 mg/kg every 24 h
	WT 1200–2000 g	10–15 mg/kg every 8–12 h
	WT > 2000 g	15 mg/kg every 6–8 h
BNF for children (2016–2017) and Blue Book (2016)	PMA < 29 PMA 29–35 PMA >35	15 mg/kg every 24 h 15 mg/kg every 12 h 15 mg/kg every 8 h
Neofax (2017)	PMA ≤ 29 and PNA 0–14 PNA >14	10–15 mg/kg every 18 h 10–15 mg/kg every 12 h
	PMA 30–36 and PNA 0–14 PNA >14	10–15 mg/kg every 12 h 10–15 mg/kg every 8 h
	PMA 37–44 and PNA 0–14 PNA >14	10–15 mg/kg every 12 h 10–15 mg/kg every 8 h
	PMA > 45	10–15 mg/kg every 6 h
FDA labeled dosage (2017)	PNA ≤ 7	LD: 15 mg/kg MD: 10 mg/kg every 12 h
	PNA >7 and ≤ 30	LD: 15 mg/kg MD: 10 mg/kg every 8 h

Recommendations were selected to illustrate that dosage recommendations were highly variable, based on the covariates PNA, PMA, GA, and weight.

1. Neonatal Formulary: Drug use in pregnancy and the first year of life. Books Wiley-Blackwell 2015. BMJ.

2. Red Book: Report of the Committee on infectious diseases. Elk Grove Village. American Academy of Pediatrics, 2015.

3. Pediatric and Neonatal Dosage Handbook. Lexi-Comp Inc., 2015–2016.

4. BNF for children: The Royal Pharmaceutical Society of Great Britain, 2016–2017 and Blue book: European Society of Paediatric Infectious Diseases and the Royal College of Paediatrics and Child Health, 2016.

5. Neofax (http://neofax.micromedexsolutions.com/neofax/neofax.php), 2017.

6. FDA Labels, https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/060180s047lbl.pdf, 2017.

^aGA, Gestational age (in weeks); LD, Loading dose; MD, Maintenance dose; PMA, Postmenstrual age (in weeks); PNA, Postnatal age (in days); Scr (in μmol/L).