Vancomycin Dosing Based on eGFR (creatinine-cystatin C)

Select an appropriate initial dose and interval for vancomycin taking into account renal function using cystatin C & creatinine

About

This dosing protocol can be used to select an appropriate initial dose and interval of vancomycin based on the CKD EPI creatinine-cystatin C eGFR (mL/min). This tool has been shown to better predict trough concentrations than clinical judgement coupled with creatinine only estimates of renal function. Providers should closely monitor patient's response to therapy to ensure appropriate treatment of infection. Early indications of changing renal function (e.g. urine output, BUN, serum creatinine) might signal a risk for accumulation and need for more frequent therapeutic drug monitoring or renal assessment.

References

Frazee E, Rule AD, Lieske JC, Kashani KB, Barreto JN, Virk A, Kuper PJ, Dierkhising RA, Leung N.

Cystatin C-Guided Vancomycin Dosing in Critically Ill Patients: A Quality Improvement Project.

American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation 2017, 69 (5): 658-666

Frazee EN, Rule AD, Herrmann SM, Kashani KB, Leung N, Virk A, Voskoboev N, Lieske JC.

Serum cystatin C predicts vancomycin trough levels better than serum creatinine in hospitalized patients: a cohort study.

Critical Care: the Official Journal of the Critical Care Forum 2014 May 29, 18 (3): R110

Created by on 29/12/2015

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1. Has the patient received > 1 dose of vancomycin in the last 4-days?

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