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Table 1 Adjustment of starting maintenance vancomycin doses according to renal function (for a 70-kg adult)

From: CAMERA2 – combination antibiotic therapy for methicillin-resistant Staphylococcus aureus infection: study protocol for a randomised controlled trial

Creatinine clearance (mL/min) Starting maintenance dosage Timing of trough (pre-dose) plasma concentration measurement
More than 90 1.5 g 12-hourly Before the fourth dose
60 to 90 1 g 12-hourly Before the fourth dose
20 to less than 60 1 g 24-hourly Before the third dose
Less than 20 1 g 48-hourly 48 hours after the first dose
On haemodialysis [58] 25 mg/kg Immediately prior to next haemodialysis session