Spectrum: Local Antimicrobial Stewardship, for Island Health

101-120 mcmol/L Low Trough

Round all doses to nearest 250mg

Age 20-39

Vancomycin 25 mg/kg loading dose then 15 mg/kg maintenance dose Q12H

Age 40-69

Vancomycin 25 mg/kg loading dose then 15 mg/kg maintenance dose Q18H

Age 70+

Vancomycin 25 mg/kg loading dose then 15 mg/kg maintenance dose Q24H