Wednesday December 21, 2005
Vancomycin dosing in CRRT
Vancomycin dosing is different in CRRT (Continuous Renal Replacement Therapy) from IHD (Intermittent HemoDialysis) as vancomycin is effectively removed during CRRT. Vancomycin is 14K daltons and CRRT filter removes upto 20K daltons size molecules. Frequent monitoring of Vancomycin level is required. Different intervals has been described from 24 to 48 hours. Most agree on 10 mg/kg every 24 hours. If patient is on CVVHDF instead of CVVHD than it might go upto 15 mg/kg per day. Ultimate goal is to keep vancomycin trough atleast between 10 - 15 mcg/ml and should not fall below 8 mcg/ml.
Related: See nice power point presentation on CRRT from Gregory M. Susla Pharm.D (Bayer) here .
References: Click to get abstract/article
1. Vancomycin dosing and monitoring - Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center (CUMC), columbia.edu
2. Antimicrobial dosing in continuous renal replacement therapy - with free registration at http://infectiousdiseasenews.com
3. CVVH Initial Drug Dosing Guidelines - from www.thedrugmonitor.com