Vancomycin Dosing/Monitoring Guidelines

  1. Ariano RE, Fine A, Sitar DS, et al.  Adequacy of a vancomycin dosing regimen in patients receiving high-flux hemodialysis.  Am J Kid Dis 2005;46:681-7.
  2. Bauer LA.  Applied Clinical Pharmacokinets.  Chapter 5:  Vancomycin.  McGraw-Hill, 2001.
  3. Bellos I, Daskalakis G, Pergialiotis V.  Relationship of vancomycin trough levels with acute kidney injury risk: an exposure–toxicity meta-analysis.  J Antimicrob Chemother 2020; doi:10.1093/jac/dkaa184.
  4. Brown M, Polisetty R, Gracely EJ, et al.  Weight based loading of vancomycin in patients on hemodialysis.  Clin Infect Dis 2011;53:164-6.
  5. Dalton BR, Rajakumar I, Langevin A, et al.  Vancomycin area under the curve to minimum inhibitory concentration ratio predicting clinical outcome: a systematic review and meta-analysis with pooled sensitivity and specificity.  Clin Microbiol Infect 2020;26:436-46.
  6. Dilworth TJ, Schulz LT, Rose WE.  Vancomycin advanced therapeutic drug monitoring: an exercise in futility or virtuous endeavor to improve drug efficacy and safety?  Clin Infect Dis 2020;ciaa1354, https://doi.org/10.1093/cid/ciaa1354.
  7. Edwards D, Pancorbo S.  Routine monitoring of serum vancomycin concentrations: waiting for proof of its value.  Clin Pharm 1987;6:652-4.
  8. Fekety R.  Vancomycin and teicoplanin.  In: Mandell GL, Bennett JE, Dolin R, eds.  Principles and practice of infectious diseases. New York, NY: Churchill Livingstone; 1995;346-53.
  9. Freeman C, et al.  Vancomycin therapeutic drug monitoring: is it necessary? Ann Pharmacother 1993;27:594-8.
  10. Frymoyer A, Guglielmo BJ, Wilson SD, et al.  Impact of a hospitalwide increase in empiric pediatric vancomycin dosing on initial trough concentrations.  Pharmacotherapy 2011;31:871-6.
  11. Frymoyer A, Hersh AL, Benet LZ, et al.  Current recommended dosing of vancomycin for children with invasive methicillin-resistant Staphylococcus aureus infections is inadequate. Pediatr Infect Dis J 2009;28:398-402.
  12. Fu CF, Huang JD, Wang JT, et al. The ratio of pre-dialysis vancomycin trough serum concentration to minimum inhibitory concentration is associated with treatment outcomes in methicillin-resistant Staphylococcus aureus bacteremia. PLOS ONE 2018;13:e0193585. https://doi.org/10.1371/journal.pone.0193585
  13. Hui K, Upjohn L, Nalder M, et al. Vancomycin dosing in chronic high-flux haemodialysis: a systematic review. Internat J Antimicrob Agents 2018;51:678–86. https://doi.org/10.1016/j.ijantimicag.2017.12.017
  14. Johnson SV, et al.  Inappropriate vancomycin prescribing based on criteria from the Centres for Disease Control and Prevention. Pharmacotherapy 1995;15:579-85.
  15. Maxson R, Pate J, Starr J. Evaluation of weight-based vancomycin dosing for hospitalized hemodialysis patients. Renal Failure 2016;38:1677–82. https://doi.org/10.1080/0886022X.2016.1229992 
  16. Nekidy WS, Cha R, Ghazi IM. Practical considerations for vancomycin dosing in hemodialysis patients: perspectives from the nephrology stewardship pharmacist
. Clinical Nephrology 2022;97:111–20. https://doi.org/10.5414/CN110664
  17. Nekidy WS, El‐Masri MM, Ghazi IM, et al. Factors predicting vancomycin therapy outcomes in hemodialysis outpatients and the role of the nephrology stewardship pharmacist. Hemodialysis Internat 2019;23:449–57. https://doi.org/10.1111/hdi.12775
  18. Pai AB, Pai MP.  Vancomycin dosing in high flux hemodialysis:  a limited sampling algorithm.  Am J Health Syst Pharm 2004;61:1812-6.
  19. Panais R, Hirsch DJ, Dipchand C, et al.  A protocolized approach to vancomycin dosing in conventional hemodialysis.  J Nephrol 2010;23:569-74.Rodvold KA, et al.  Routine monitoring of serum vancomycin concentrations:  can waiting be justified?  Clin Pharm 1987;6:655-8.
  20. Rybak MJ, Le J, Lodise TP, et al.  Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: A revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists.  Am J Health-Syst Pharm 2020;77:835–63.
  21. Rybak M, Lomaestro B, Rotschafer JC, et al.  Therapeutic monitoring of vancomycin in adult patients:  A consensus review of the American Society of Health-System Pharmacists (ASHP), the Infectious Diseases Society of America (IDSA), the Society of Infectious Diseases Pharmacists (SIDP).  Am J Health Syst Pharm 2009;66:82-98.
  22. Saunders NJ.  Vancomycin administration and monitoring reappraisal. J Antimicrob Chemother 1995;36:279-82.
  23. Saunders NJ.  Why monitor peak vancomycin concentrations? Lancet 1994;344:1748-50.
  24. Shalansky S. Rationalization of vancomycin serum concentration monitoring. Can J Hosp Pharm 1995;48:17-24.
  25. Sun LXL, Liu KWD, Lynch S, et al. Validation of a weight threshold-based vancomycin dosing protocol for patients undergoing intermittent hemodialysis. Can J Hosp Pharm 2019;72:369–76.
  26. Van Hal SJ, Paterson DL, Lodise TP. Systematic review and meta-analysis of vancomycin-induced nephrotoxicity associated with dosing schedules that maintain troughs between 15 and 20 milligrams per liter. Antimicrob Agents Chemother 2013;57:734–44.
  27. Vandecasteele SJ, DeBacquer D, DeVriese AS.  Implementation of a dose calculator for vancomycin to achieve target trough levels of 15-20 µg/mL in persons undergoing hemodialysis.  Clin Infect Dis 2011;53:124-9.
  28. Wright WF, Jorgensen SCJ, Spellberg B.  Heaping the pelion of vancomycin on the ossa of MRSA: back to basics in clinical care and guidelines.  Clin Infect Dis 2020;ciaa1360, https://doi.org/10.1093/cid/ciaa1360.
  29. Zelenitsky SA, Ariano RE, McCrae ML, et al.  An initial vancomycin dosing protocol to achieve therapeutic serum concentrations in hemodialysis patients.  Clin Infect Dis 2012;55:527-33.
  30. Zimmermann AE, et al.  Association of vancomycin serum concentrations with outcomes in patients with gram-positive bacteremia. Pharmacotherapy 1995;15:85-91.