Spectrum: Local Antimicrobial Stewardship, for Eastern Health

40-60 mcmol/L

This nomogram is for the calculation of initial MAINTENANCE dose for patients with

stable renal function. Dose should be adjusted as required based on vancomycin trough levels.

Age 20-39

Q8H based on Actual body weight:

40-50 kg = 750 mg
51-70 kg = 1000 mg
71-90 kg = 1250 mg
91 kg or more: 1500 mg

Age 40-69

Q12H based on Actual body weight:

40-50 kg = 750 mg
51-70 kg = 1000 mg
71-90 kg = 1250 mg
91 kg or more: 1500 mg

Age 70-79

Q18H based on Actual body weight:

40-50 kg = 750 mg
51-70 kg = 1000 mg
71-90 kg = 1250 mg
91 kg or more: 1500 mg

Note

In elderly patients (age > 60) with low muscle mass, use clinical judgement as SCr may not reflect renal function accurately