![]() Vancomycin dosing in patients receiving renal replacement therapy is complex and usually requires expert clinical judgment in conjunction with assessment of unique patient-specific factors. The use of two drug concentrations allows for patient-specific estimations of all pharmacokinetic parameters using the Sawchuk-Zaske method.ĭosing Recommendations for Renal Replacement Therapy (RRT) These drug levels can either be obtained after the first dose is given (non-steady state) or once steady state is achieved (after the third dose is administered). The most optimal method of monitoring vancomycin therapy is to obtain two drug levels (such as a peak and trough concentration) during the same dosing interval. Once patient-specific values of Kel and Vd have been determined, traditional one-compartment pharmacokinetic equations are used to identify a dose and its associated peak, trough, and AUC/MIC values. Use patient-specific Kel and Vd for additional calculations Vd is the volume of distribution (in liters) dose is the vancomycin dose (in milligrams) T inf is the vancomycin infusion time (in hours) k is the elimination constant (Kel, in hr -1) C max is the true peak concentration C min is the true trough concentration (if at steady state) or is 0 (zero) if not at steady state 4. Once the most likely values of Kel and Vd have been estimated, one-compartment pharmacokinetic equations are used to identify a dose and its associated peak, trough, and AUC/MIC values.Convert AUC to AUC:MIC ratio over 24 hours $$
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