{"id":5524,"date":"2020-05-26T15:24:28","date_gmt":"2020-05-26T05:24:28","guid":{"rendered":"https:\/\/doseme-rx.com\/?p=5524"},"modified":"2021-04-13T16:56:15","modified_gmt":"2021-04-13T06:56:15","slug":"renal-dose","status":"publish","type":"post","link":"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose","title":{"rendered":"Vancomycin Renal Dose"},"content":{"rendered":"\n<p>Vancomycin&nbsp;is an antibiotic originally isolated from the bacteria&nbsp;<em>Streptococcus orientalis.<\/em><\/p>\n\n\n\n<p>It was discovered in the 1950&rsquo;s but it gained popularity in the 1970&rsquo;s for treating antibiotic-resistant infections, particularly penicillin-resistant staphylococcal infections.<\/p>\n\n\n\n<p>Vancomycin&nbsp;is a&nbsp;glycopeptide&nbsp;antibiotic that stops bacteria from making peptidoglycan, the main component of bacterial cell walls. It is an effective antibiotic treatment against Gram-positive bacteria that have peptidoglycan in their cell walls.<\/p>\n\n\n\n<p>Despite its useful properties, many studies have shown&nbsp;vancomycin&nbsp;therapy&nbsp;damages the kidneys and other organs.<\/p>\n\n\n\n<p>There are ways to safely manage and make&nbsp;dosage adjustments&nbsp;to prevent further harm from occurring.&nbsp;<\/p>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Uses of&nbsp;Vancomycin<\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"740\" height=\"380\" src=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/05\/Doctor-Nurse.jpg\" alt=\"2020 Vancomycin Dosing Guidelines: A Physician's Perspective\" class=\"wp-image-5399\" srcset=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/05\/Doctor-Nurse.jpg 740w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/05\/Doctor-Nurse-300x154.jpg 300w\" sizes=\"(max-width: 740px) 100vw, 740px\" \/><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>The Food and Drug Administration (FDA) has approved two different kinds of&nbsp;vancomycin.<\/p>\n\n\n\n<p>One type is given by mouth (orally), and another is injected into a vein, or intravenously (IV). The administration method depends on the type of infection and how serious it is.&nbsp;<\/p>\n\n\n\n<p>Oral&nbsp;vancomycin&nbsp;is used to treat infection-induced diarrhea, including cases caused by <em>Clostridiodes <\/em>(<em>Clostridium) difficile<\/em>.<\/p>\n\n\n\n<p>Additionally, it is used to treat enterocolitis caused by methicillin-resistant <em>Staphylococcus aureus (MRSA). <\/em><\/p>\n\n\n\n<p>However, when&nbsp;vancomycin&nbsp;is used for infections in the digestive system, it cannot get into the blood and treat other infections.<\/p>\n\n\n\n<p>For this reason,&nbsp;vancomycin&nbsp;is injected IV for all other infections besides&nbsp;<em>C. difficile and MRSA enterocolitis<\/em>.&nbsp;<\/p>\n\n\n\n<p>IV&nbsp;vancomycin&nbsp;treats bacterial infections from&nbsp;methicillin-resistant&nbsp;<em>Staphylococcus aureus&nbsp;<\/em>,&nbsp;<em>Enterococcus faecalis, and&nbsp;<\/em>methicillin-resistant&nbsp;<em>Staphylococcus epidermis&nbsp;<\/em>(MRSE).&nbsp;MRSA&nbsp;and MRSE are both resistant to beta-lactam antibiotics (for example, oxacillin), which are commonly used to treat most staph infections.<\/p>\n\n\n\n<p>Vancomycin&nbsp;can also be used for a variety of other serious or severe infections, including:&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Skin and soft tissue infections<\/li><li>Infection of the inner lining and valves of the heart (endocarditis)<\/li><li>Infections in the blood (bacteremia)<\/li><li>Blood poisoning (septicemia)<\/li><li>Lower respiratory tract infections<\/li><li>Osteomyelitis&nbsp;(Infection in the bone)<\/li><li>Bacterial meningitis<\/li><\/ul>\n\n\n\n<p>Vancomycin&nbsp;is also used to treat other conditions off-label, such as:&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Intra-abdominal infections due to&nbsp;MRSA<\/li><li>Necrotizing skin and soft tissue infections<\/li><li>Prosthetic joint infections<\/li><li>Surgical site infections<\/li><li>Prevention of surgical infections<\/li><li>Bacterial infections in the eye (bacterial endophthalmitis)<\/li><li>Prevention of Group B streptococcal infections in newborns<\/li><\/ul>\n\n\n\n<p>Vancomycin&nbsp;is useful for treating infections in patients who are allergic to penicillin or cephalosporins.<\/p>\n\n\n\n<p>It is important to note that&nbsp;vancomycin&nbsp;and other antibiotics are not effective in treating viral infections.<\/p>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Dosing of IV&nbsp;Vancomycin<\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"740\" height=\"380\" src=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/05\/Laboratory-staff.jpg\" alt=\"vancomycin-dosing-physician's-perspective\" class=\"wp-image-5402\" srcset=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/05\/Laboratory-staff.jpg 740w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/05\/Laboratory-staff-300x154.jpg 300w\" sizes=\"(max-width: 740px) 100vw, 740px\" \/><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>In March 2020, <a href=\"https:\/\/doseme-rx.com\/news\/20200330-vancomycin-dosing-guidelines-what-to-know\">new vancomycin dosing guidelines<\/a> from leading infectious disease and pharmacy groups were released.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Non-obese adult patients&nbsp;with&nbsp;normal&nbsp;kidney function<\/strong> begin with a dosing of 15 to 20 mg\/kg IV (based on the patient\u2019s actual body weight), given every 8 to 12 hours.<\/li><li><strong>Non-obese children with normal kidney function<\/strong> between the ages of 3 months and 12 years old are given 60-80 mg\/kg\/day, with doses divided up and given every 6 hours.<\/li><li><strong>In children who are 12 years and older<\/strong>, the recommended dose is 60-70 mg\/kg\/day, with doses divided up and given every 6 to 8 hours. <\/li><li><strong>Elderly patients and\/or patients with impaired kidney function<\/strong> receive lower doses of vancomycin, while obese patients may receive higher doses. <\/li><\/ul>\n\n\n\n<p>Vancomycin is processed in the kidneys, and it is important to give enough drug to combat the infection without causing damage.<\/p>\n\n\n\n<p>In order for&nbsp;vancomycin&nbsp;to work correctly, a certain concentration needs to be maintained in the blood.&nbsp;Vancomycin&nbsp;has a narrow therapeutic window, and it is easy to under or overdose a patient.<\/p>\n\n\n\n<p>Blood work is done to ensure levels of the drug remain within this window to prevent organ damage or antibiotic resistance. This also helps to determine when the next dose should be administered to the patient.&nbsp;<\/p>\n\n\n\n<p>The&nbsp;half-life&nbsp;of a drug is how long the body takes to break down one-half of a given dose.<\/p>\n\n\n\n<p>In patients with good renal function, the&nbsp;half-life&nbsp;of&nbsp;vancomycin&nbsp;is between 4 to 6 hours; in patients lacking functional kidneys, the&nbsp;half-life&nbsp;can be as long as is 7.5 days. Every person will eliminate&nbsp;vancomycin&nbsp;at a different rate and dosing can be tailored to an individual patient.&nbsp;<\/p>\n\n\n\n<p>In 2009, guidelines were released stating that patients\u2019 dosing should be monitored by <a href=\"https:\/\/doseme-rx.com\/news\/20191119-vancomycin-trough-level-recommendations\">trough levels<\/a>. <\/p>\n\n\n\n<p>The trough level measurement is the lowest concentration of drug in the blood before the next dose is given.<\/p>\n\n\n\n<p>It was previously recommended that patients maintain a trough levels of 10&nbsp;mcg\/mL for all infections; severe or complicated infections required a concentration of 15 to 20&nbsp;mcg\/mL.<\/p>\n\n\n\n<p>This&nbsp;target trough&nbsp;level was chosen to make sure patients were receiving enough drug to kill the infection, but not too much drug that could cause serious damage to the kidneys.<\/p>\n\n\n\n<p>In March 2020, new guidelines were released for&nbsp;vancomycin&nbsp;dosing recommending a shift away from trough levels:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>For patients that are not obese<\/strong>: an initial&nbsp;loading dose&nbsp;of 20to 35 milligrams\/kilogram (mg\/kg) up to a maximum of can be given to a patient with a serious&nbsp;MRSA&nbsp;infection&nbsp;or other illness so that effective serum levels&nbsp;can be reached quickly.<\/li><li><strong>If the patient is obese<\/strong>: the recommended loading dose is 20 to 25mg\/kg .<\/li><\/ul>\n\n\n\n<p>In both cases, the maximum recommended loading dose is 3000mg. After bloodwork is done, a computer program calculates the correct dose. Doctors or other prescribers will give patients the correct amount of&nbsp;vancomycin&nbsp;to reach a target area under the curve (AUC) concentration between 400 to 600 mg*h\/L.&nbsp;<\/p>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Vancomycin&nbsp;Dosing&nbsp;in Patients undergoing Dialysis<\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"1024\" height=\"526\" src=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/03\/vanc-hemodialysis-blog-01-1024x526.png\" alt=\"vancomycin dosing in hemodialysis patients\" class=\"wp-image-3976\" srcset=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/03\/vanc-hemodialysis-blog-01-1024x526.png 1024w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/03\/vanc-hemodialysis-blog-01-300x154.png 300w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/03\/vanc-hemodialysis-blog-01-768x394.png 768w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>When someone develops end-stage kidney failure, their kidneys can no longer function properly.<\/p>\n\n\n\n<p>As a result, the patient needs dialysis, which replicates what the kidneys normally do in the body; this includes removing salt, waste and extra water from the body.<\/p>\n\n\n\n<p>Vancomycin is processed by the kidneys, and this treatment affects drug dosing.<\/p>\n\n\n\n<p>Factors to consider when dosing vancomycin in a dialysis patient include when the dose is given (how often, and whether it is before or after dialysis treatment), and the amount of time in between administration and dialysis treatments.<\/p>\n\n\n\n<p>Studies have shown that dosing to a predialysis concentration of 10 to 20 mg\/L results in an AUC of 250 to 450 mg*h\/L, which is lower than the target AUC of 400 to 600 mg*h\/L. As a result, predialysis concentrations should be maintained at 15 to 20 mg\/L to achieve this target AUC.<\/p>\n\n\n\n<p>It is recommended to give maintenance doses of vancomycin with each dialysis session so that an effective concentration of drug remains in the blood to treat infections.<\/p>\n\n\n\n<p>Larger doses may need to be given in between dialysis sessions to prevent serum concentrations of the drug from dropping.<\/p>\n\n\n\n<p>To test for serum concentration of vancomycin, wait at least 2 hours after dialysis treatment to allow the drug to enter the blood from tissues.<\/p>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Side Effects of IV&nbsp;Vancomycin<\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"1024\" height=\"526\" src=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/03\/vancomycin-dosing-obese-blog-01-1024x526.png\" alt=\"Vancomycin dosing in obese and morbidly obese\" class=\"wp-image-3967\" srcset=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/03\/vancomycin-dosing-obese-blog-01-1024x526.png 1024w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/03\/vancomycin-dosing-obese-blog-01-300x154.png 300w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/03\/vancomycin-dosing-obese-blog-01-768x394.png 768w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>You can find our full list of <a href=\"https:\/\/doseme-rx.com\/news\/20200808-vancomycin-side-effects\">Vancomycin Side Effects here<\/a>. Common adverse side effects of IV administration of&nbsp;vancomycin in particular&nbsp;include:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Low blood pressure (hypotension)<\/li><li>Muscle pain or spasms in the chest and back<\/li><li>Allergic reactions, such as anaphylaxis or hives<\/li><li>Shortness of breath or wheezing&nbsp;<\/li><li>Dizziness<\/li><\/ul>\n\n\n\n<p>Other&nbsp;adverse&nbsp;effects&nbsp;that are less common include:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Drug fever<\/li><li>Chills<\/li><li>Inflammation of a vein at the injection site (phlebitis)<\/li><li>An increase in white blood cell count (eosinophilia)<\/li><\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Red Man Syndrome<\/h3>\n\n\n\n<p>When&nbsp;vancomycin&nbsp;is administered too quickly intravenously,&nbsp;red man syndrome&nbsp;can develop.<\/p>\n\n\n\n<p>Symptoms tend to begin 4 to 10 minutes after administration, including:&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Itching or uncomfortable skin (pruritus)&nbsp;<\/li><li>Flushing<\/li><li>Red skin rash on the&nbsp;upper body, face, and neck<\/li><\/ul>\n\n\n\n<p>Between 3.7% to 47% of patients develop&nbsp;red man syndrome. The faster the infusion of&nbsp;vancomycin, the more likely a patient is to develop the syndrome.<\/p>\n\n\n\n<p>The most severe cases occur in children and patients who are 40 years old or younger.<\/p>\n\n\n\n<p>Antihistamines, such as cimetidine and diphenhydramine, can be given before infusion to help prevent&nbsp;red man syndrome&nbsp;from occurring. <\/p>\n\n\n\n<p>However, the most effective method is administering the drug slowly over 60-120 minutes.&nbsp;<\/p>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Nephrotoxicity&nbsp;of&nbsp;Vancomycin<\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"1024\" height=\"526\" src=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/04\/Complex-criticallyillBlog-01-1024x526.png\" alt=\"Vancomycin dosing in critically-ill patients\" class=\"wp-image-4002\" srcset=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/04\/Complex-criticallyillBlog-01-1024x526.png 1024w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/04\/Complex-criticallyillBlog-01-300x154.png 300w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/04\/Complex-criticallyillBlog-01-768x394.png 768w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>Vancomycin&nbsp;has been shown have&nbsp;nephrotoxicity, which can lead to acute kidney injury (AKI).<\/p>\n\n\n\n<p>This is most likely caused by the drug stopping blood flow and oxygen from reaching the kidneys.<\/p>\n\n\n\n<p>Patients are at a higher risk for developing AKI if they have underlying&nbsp;renal function impairment, use other nephrotoxic medications, are elderly, or are dehydrated. There are multiple ways that AKI can be defined.<\/p>\n\n\n\n<p> These include:<\/p>\n\n\n\n<ol class=\"wp-block-list\" type=\"1\"><li>An increase in&nbsp;serum creatinine&nbsp;of &gt;0.5 mg\/dL or<\/li><li>A 50% increase from baseline in two consecutive daily readings, or<\/li><li>A decrease in calculated&nbsp;creatinine clearance&nbsp;of 50% from baseline on two consecutive days in the absence of an alternative explanation.<\/li><li>Newer studies suggest that a more sensitive threshold of an increase in&nbsp;serum creatinine&nbsp;&gt;0.3 mg\/dL over a 48-hour period may be an indicator of AKI.<\/li><\/ol>\n\n\n\n<p>A safe way to determine&nbsp;vancomycin&nbsp;dosing&nbsp;is to base it on a patient&rsquo;s estimated&nbsp;creatinine clearance; this helps prevent overworking the kidneys.&nbsp;<\/p>\n\n\n\n<p>The main function of the kidneys is to filter the blood and remove toxins from the body.<\/p>\n\n\n\n<p>When a patient has&nbsp;renal function failure&nbsp;(their kidneys no longer work),&nbsp;hemodialysis&nbsp;can be done.<\/p>\n\n\n\n<p>This procedure uses an artificial kidney, or dialyzer, to clean the blood.<\/p>\n\n\n\n<p>An infection in the blood called&nbsp;bacteremia&nbsp;can develop during&nbsp;hemodialysis&nbsp;treatment and&nbsp;vancomycin&nbsp;is used to treat it. However, these patients cannot properly process the drug, and a&nbsp;dose adjustment&nbsp;needs to be made so it does not cause any further damage.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Ototoxicity&nbsp;of&nbsp;Vancomycin<\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"740\" height=\"380\" src=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/03\/VancoDosingGuidelines-ClinicalSummary-Nobutton-1-100.jpg\" alt=\"Vancomycin Dosing Guidelines: A Clinical Summary\" class=\"wp-image-5201\" srcset=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/03\/VancoDosingGuidelines-ClinicalSummary-Nobutton-1-100.jpg 740w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/03\/VancoDosingGuidelines-ClinicalSummary-Nobutton-1-100-300x154.jpg 300w\" sizes=\"(max-width: 740px) 100vw, 740px\" \/><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p>Vancomycin&nbsp;has been shown to induce&nbsp;ototoxicity, an ear condition where the auditory nerve and cochlea are damaged.<\/p>\n\n\n\n<p>It rarely occurs when&nbsp;vancomycin&nbsp;is given on its own; however, it is quite common in patients taking high doses as monotherapy or if it is combined with other ototoxic medication (aminoglycosides, loop diuretics,&nbsp;and anticancer drugs).<\/p>\n\n\n\n<p>Patients who have underlying hearing loss conditions are also commonly affected.<\/p>\n\n\n\n<p>Vancomycin&nbsp;treatment should be stopped if patients lose their hearing or balance, or experience ringing in the ears (tinnitus).<\/p>\n\n\n\n<p>In some cases,&nbsp;ototoxicity&nbsp;induced by&nbsp;vancomycin&nbsp;treatment may be irreversible.<\/p>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">Related Articles<\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/doseme-rx.com\/news\/20191119-vancomycin-trough-level-recommendations\"><img decoding=\"async\" width=\"740\" height=\"380\" src=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/11\/Vanco-guideline-09v19.png\" alt=\"New vancomycin guidelines - what's new?\" class=\"wp-image-4522\" srcset=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/11\/Vanco-guideline-09v19.png 740w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2019\/11\/Vanco-guideline-09v19-300x154.png 300w\" sizes=\"(max-width: 740px) 100vw, 740px\" \/><\/a><figcaption><strong><a href=\"https:\/\/doseme-rx.com\/news\/20191119-vancomycin-trough-level-recommendations\">Vancomycin Trough Levels: Upcoming Therapeutic Drug Monitoring Recommendations<\/a><\/strong><\/figcaption><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/doseme-rx.com\/news\/20200506-vancomycin-dosing-guidelines-physician-perspective\"><img decoding=\"async\" width=\"740\" height=\"380\" src=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/05\/Preparing-Physicians-For-AUC-blog.jpg\" alt=\"\" class=\"wp-image-5537\" srcset=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/05\/Preparing-Physicians-For-AUC-blog.jpg 740w, https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/05\/Preparing-Physicians-For-AUC-blog-300x154.jpg 300w\" sizes=\"(max-width: 740px) 100vw, 740px\" \/><\/a><figcaption><strong><a href=\"https:\/\/doseme-rx.com\/news\/20200506-vancomycin-dosing-guidelines-physician-perspective\">How Can We Prepare Physicians for AUC?<\/a><\/strong><\/figcaption><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">References <\/h2>\n\n\n\n<p>Hale CM, Seabury RW, Steele JM, Darko W, Miller CD. Are&nbsp;Vancomycin&nbsp;Trough&nbsp;Concentrations&nbsp;of 15 to 20 mg\/L associated with increased attainment of an&nbsp;AUC\/MIC \u2265 400 in Patients with Presumed&nbsp;MRSA&nbsp;Infection? J Pharm Pract. 2017;30(3):329-335.&nbsp;<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27074786\">https:\/\/www<\/a><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27074786\" target=\"_blank\" rel=\"noreferrer noopener\">.<\/a><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27074786\">ncbi.nlm.nih.gov\/pubmed\/27074786<\/a><\/p>\n\n\n\n<p>Hazlewood KA, Brouse SD, Hall RG.&nbsp;Vancomycin-Associated&nbsp;Nephrotoxicity: Grave Concern or Death by Character Assassination? Am J Med. 2010;123(2):182.e1-182.e1827.&nbsp;<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2813201\/\">https:\/\/www.ncbi.nlm.nih.gov\/<\/a><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2813201\/\" target=\"_blank\" rel=\"noreferrer noopener\">pmc<\/a><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2813201\/\">\/articles\/PMC2813201\/<\/a><\/p>\n\n\n\n<p>MedlinePlus Drug Information.&nbsp;Vancomycin&nbsp;Injection. Revised April 15, 2016. Accessed April 7, 2020.&nbsp;<a href=\"https:\/\/medlineplus.gov\/druginfo\/meds\/a601167.html\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/medlineplus.gov\/druginfo\/meds\/a601167.html<\/a><\/p>\n\n\n\n<p>Levine, DP. (2006).&nbsp;Vancomycin: A History. Clin Infect Dis. 2006;42 Suppl 1:S5-S12. Accessed April 8, 2020.&nbsp;<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/16323120\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/16323120<\/a><\/p>\n\n\n\n<p>Patel S, Preuss CV, Bernice F. \u00ab\u00a0Vancomycin.\u00a0\u00bb StatPearls [Internet]. 28 February 2020. Accessed April 7, 2020.&nbsp;<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459263\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459263\/<\/a><\/p>\n\n\n\n<p>Rybak MJ, Le J, Lodise TP, Levine DP, Bradley JS, et al. Therapeutic Monitoring of&nbsp;Vancomycin: A Revised Consensus Guideline. Am J Health Syst Pharm [Epub ahead of print.] Accessed April 7, 2020.&nbsp;<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/32191793\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/32191793<\/a><\/p>\n\n\n\n<p>Taylor ME, Allon M. Practical&nbsp;Vancomycin&nbsp;Dosing&nbsp;in&nbsp;Hemodialysis&nbsp;Patients in the Era of Emerging&nbsp;Vancomycin&nbsp;Resistance: A Single-Center Experience. Am J Kidney Dis. 2010;55(6):1163-1165.&nbsp;<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4019019\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4019019\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Vancomycin&nbsp;is an antibiotic originally isolated from the bacteria&nbsp;Streptococcus orientalis. It was discovered in the 1950&rsquo;s but it gained popularity in the 1970&rsquo;s for treating antibiotic-resistant infections, particularly penicillin-resistant staphylococcal infections. Vancomycin&nbsp;is a&nbsp;glycopeptide&nbsp;antibiotic that stops bacteria from making peptidoglycan, the main component of bacterial cell walls. It is an effective antibiotic treatment against Gram-positive bacteria that [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":7644,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[26],"tags":[],"article-type":[49],"class_list":["post-5524","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-vancomycin"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Vancomycin Renal Dose | Renal Function Impact, Body Weight Considerations, Trough Levels and More | DoseMeRx<\/title>\n<meta name=\"description\" content=\"Understand how Vancomycin Renal Dosing works, what the considerations are, and the guidelines for administering in a hospital setting. Read more here.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Vancomycin Renal Dose | Renal Function Impact, Body Weight Considerations, Trough Levels and More | DoseMeRx\" \/>\n<meta property=\"og:description\" content=\"Understand how Vancomycin Renal Dosing works, what the considerations are, and the guidelines for administering in a hospital setting. Read more here.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose\" \/>\n<meta property=\"og:site_name\" content=\"DoseMeRx\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/DoseMeApp\/\" \/>\n<meta property=\"article:published_time\" content=\"2020-05-26T05:24:28+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-04-13T06:56:15+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/06\/14-1024x576.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1024\" \/>\n\t<meta property=\"og:image:height\" content=\"576\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Nicola Hunter\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@DoseMeApp\" \/>\n<meta name=\"twitter:site\" content=\"@DoseMeApp\" \/>\n<meta name=\"twitter:label1\" content=\"\u00c9crit par\" \/>\n\t<meta name=\"twitter:data1\" content=\"Nicola Hunter\" \/>\n\t<meta name=\"twitter:label2\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data2\" content=\"10 minutes\" \/>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Vancomycin Renal Dose | Renal Function Impact, Body Weight Considerations, Trough Levels and More | DoseMeRx","description":"Understand how Vancomycin Renal Dosing works, what the considerations are, and the guidelines for administering in a hospital setting. Read more here.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose","og_locale":"fr_FR","og_type":"article","og_title":"Vancomycin Renal Dose | Renal Function Impact, Body Weight Considerations, Trough Levels and More | DoseMeRx","og_description":"Understand how Vancomycin Renal Dosing works, what the considerations are, and the guidelines for administering in a hospital setting. Read more here.","og_url":"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose","og_site_name":"DoseMeRx","article_publisher":"https:\/\/www.facebook.com\/DoseMeApp\/","article_published_time":"2020-05-26T05:24:28+00:00","article_modified_time":"2021-04-13T06:56:15+00:00","og_image":[{"width":1024,"height":576,"url":"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/06\/14-1024x576.png","type":"image\/png"}],"author":"Nicola Hunter","twitter_card":"summary_large_image","twitter_creator":"@DoseMeApp","twitter_site":"@DoseMeApp","twitter_misc":{"\u00c9crit par":"Nicola Hunter","Dur\u00e9e de lecture estim\u00e9e":"10 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose#article","isPartOf":{"@id":"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose"},"author":{"name":"Nicola Hunter","@id":"https:\/\/doseme-rx.com\/fr#\/schema\/person\/6c6769e1f0b02564d00c6693857210d9"},"headline":"Vancomycin Renal Dose","datePublished":"2020-05-26T05:24:28+00:00","dateModified":"2021-04-13T06:56:15+00:00","mainEntityOfPage":{"@id":"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose"},"wordCount":2012,"commentCount":0,"image":{"@id":"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose#primaryimage"},"thumbnailUrl":"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/06\/14.png","articleSection":["Vancomycin"],"inLanguage":"fr-FR","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose#respond"]}]},{"@type":"WebPage","@id":"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose","url":"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose","name":"Vancomycin Renal Dose | Renal Function Impact, Body Weight Considerations, Trough Levels and More | DoseMeRx","isPartOf":{"@id":"https:\/\/doseme-rx.com\/fr#website"},"primaryImageOfPage":{"@id":"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose#primaryimage"},"image":{"@id":"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose#primaryimage"},"thumbnailUrl":"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/06\/14.png","datePublished":"2020-05-26T05:24:28+00:00","dateModified":"2021-04-13T06:56:15+00:00","author":{"@id":"https:\/\/doseme-rx.com\/fr#\/schema\/person\/6c6769e1f0b02564d00c6693857210d9"},"description":"Understand how Vancomycin Renal Dosing works, what the considerations are, and the guidelines for administering in a hospital setting. Read more here.","breadcrumb":{"@id":"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose"]}]},{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose#primaryimage","url":"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/06\/14.png","contentUrl":"https:\/\/doseme-rx.com\/wp-content\/uploads\/2020\/06\/14.png","width":2240,"height":1260},{"@type":"BreadcrumbList","@id":"https:\/\/doseme-rx.com\/fr\/vancomycin\/articles\/renal-dose#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/doseme-rx.com\/fr"},{"@type":"ListItem","position":2,"name":"Vancomycin Renal Dose"}]},{"@type":"WebSite","@id":"https:\/\/doseme-rx.com\/fr#website","url":"https:\/\/doseme-rx.com\/fr","name":"DoseMeRx","description":"Choose us for our world-leading Bayesian dosing software. Stay with us for our best-in-class customer service.","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/doseme-rx.com\/fr?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Person","@id":"https:\/\/doseme-rx.com\/fr#\/schema\/person\/6c6769e1f0b02564d00c6693857210d9","name":"Nicola Hunter","image":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/secure.gravatar.com\/avatar\/02e206174499150c025ce2682b2ee353f284349ff867886a3f957d50c95af6fe?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/02e206174499150c025ce2682b2ee353f284349ff867886a3f957d50c95af6fe?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/02e206174499150c025ce2682b2ee353f284349ff867886a3f957d50c95af6fe?s=96&d=mm&r=g","caption":"Nicola Hunter"},"url":"https:\/\/doseme-rx.com\/fr\/author\/nicola-hunter"}]}},"_links":{"self":[{"href":"https:\/\/doseme-rx.com\/fr\/wp-json\/wp\/v2\/posts\/5524","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doseme-rx.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/doseme-rx.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/doseme-rx.com\/fr\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/doseme-rx.com\/fr\/wp-json\/wp\/v2\/comments?post=5524"}],"version-history":[{"count":24,"href":"https:\/\/doseme-rx.com\/fr\/wp-json\/wp\/v2\/posts\/5524\/revisions"}],"predecessor-version":[{"id":7664,"href":"https:\/\/doseme-rx.com\/fr\/wp-json\/wp\/v2\/posts\/5524\/revisions\/7664"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/doseme-rx.com\/fr\/wp-json\/wp\/v2\/media\/7644"}],"wp:attachment":[{"href":"https:\/\/doseme-rx.com\/fr\/wp-json\/wp\/v2\/media?parent=5524"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doseme-rx.com\/fr\/wp-json\/wp\/v2\/categories?post=5524"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doseme-rx.com\/fr\/wp-json\/wp\/v2\/tags?post=5524"},{"taxonomy":"article-type","embeddable":true,"href":"https:\/\/doseme-rx.com\/fr\/wp-json\/wp\/v2\/article-type?post=5524"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}