Pharmacist's Toolkit

This calculator is undergoing validation. Cross-check all calculations against primary sources or your institutional reference before clinical use.

Vancomycin Dosing Calculator

AUC-targeted dosing for adult patients. For empiric initial dosing and dose adjustment based on measured levels.

Dosing approach: AUC-targeted

This calculator uses AUC-targeted dosing exclusively, consistent with ASHP/IDSA 2020 vancomycin therapeutic monitoring guidelines. Trough-based empiric dosing is not offered because:

  • ASHP/IDSA 2020 guidelines recommend AUC as the primary efficacy and safety target.
  • Trough-based empiric dosing can produce recommendations that exceed safe AUC thresholds in certain patient populations (small weight, moderate renal function, extended intervals).
  • AUC-targeted dosing inherently respects the maximum safe exposure threshold (AUC < 600 mg·h/L).

Predicted trough is displayed for reference but is not used as a target. For established TDM with measured levels, trough may still inform dose adjustment per institutional protocol.

Patient

Weight
kg
Height
cm

When checked, the calculator displays a prominent critical illness notice, uses an upper-range loading dose (30 mg/kg actual body weight, max 3000 mg) for severe infections, and emphasizes early TDM. The PK model (Buelga 2005 vs Adane 2015) is still selected based on body habitus, not critical illness.

Indication

Examples: uncomplicated SSTI, uncomplicated UTI, mild-to-moderate pneumonia, uncomplicated bacteremia without complications.

Loading dose generally not required; may be considered case-by-case (e.g., obesity, sepsis physiology, delayed time to therapeutic exposure).
TDM recommended within 48–72 hours per institutional protocol.
Non-severe infection
Target AUC: 400–600 mg·h/L (midpoint 450)
Dose selection targets the AUC midpoint. Switch to Custom to override. Predicted trough is shown for reference only and is not used as a dosing target.

Measured Levels (Optional for Empiric Dosing)

Leave blank for empiric initial dose recommendations. For dose adjustment, enter two post-distribution levels drawn during the same dosing interval.