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