💉 Vancomycin Empiric Dosing
Empiric vancomycin loading dose, maintenance dose and dosing interval from weight and creatinine clearance, AUC-guided per the 2020 consensus. Browser-side, instant.
Vancomycin Empiric Dosing
Weight (actual) (kg)
Creatinine clearance (CrCl) (mL/min)
Give a loading dose?
When to use
Choose an empiric starting regimen for adults; it does not replace TDM/Bayesian AUC adjustment, which should be obtained within 24–48 h.
How it works
Loading 25 mg/kg actual weight (cap 3000 mg); maintenance 15–20 mg/kg; interval by CrCl (≥ 90 q8–12h, 50–89 q12h, 20–49 q24h). Target AUC/MIC 400–600.
Key points
- Start by actual body weight; in obesity load 20–25 mg/kg and monitor earlier.
- Obtain TDM early — the formula alone cannot guarantee the AUC target.
- AKI, haemodialysis and CRRT require separate dosing approaches.
- Monitor renal function; avoid stacking nephrotoxins.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.