Table 1.

Recommendations for patients receiving hemodialysis on the basis of the revised vancomycin consensus guidelines (3)

Dosing RecommendationsMonitoring Recommendations
▪ Weight-based initial dosing recommendations with actual body weight should be used.
▪ A maximal loading dose of 3000 mg is recommended for patients who are obese.
▪ A 30% larger vancomycin dose should be considered if infused intradialytically.
▪ Vancomycin infusion rate should not exceed 1 g/h, even if infused intradialytically.
▪ TDM should be performed for all patients to individualize maintenance doses.
▪ Targeting predialysis concentrations between 15–20 mg/L is likely to attain the efficacy target 24-hour AUC/MIC ratio of 400–600, assuming an MIC of ≤1 mg/L.
  • TDM, therapeutic serum drug concentration monitoring; AUC/MIC, area under the serum concentration-time curve/minimum inhibitory concentration.