Spectrum: Local Antimicrobial Stewardship, for Island Health

40-60 mcmol/L High Trough

Round all doses to nearest 250mg

Age 20-29

Vancomycin 25 mg/kg loading dose then 15 mg/kg maintenance dose Q6H

Age 30-39

Vancomycin 25 mg/kg loading dose then 15 mg/kg maintenance dose Q6-8H

If more aggressive therapy is desired, select more frequent dosing interval

Age 40-59

Vancomycin 25 mg/kg loading dose then 15 mg/kg maintenance dose Q8H

Age 60-69

Vancomycin 25 mg/kg loading dose then 15 mg/kg maintenance dose Q8-12H

If more aggressive therapy is desired, select more frequent dosing interval

Age 70+

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