Evaluation of weight-based vancomycin dosing for hospitalized hemodialysis patients

Figures & data

Table 1. Weight-based vancomycin dosing for IHD patients.

Total body weight (kg)	Maintenance dose (mg)
<75	500
75–104.9	750
105–129.9	1000
>130	1250

Table 2. Baseline characteristics.

Characteristics	Pre-protocol(n = 94)	Post-protocol(n = 51)
Mean ± SD, age (years)	62 ± 13	63 ± 15
Mean ± SD, weight (kg)	86 ± 28	85 ± 25
Mean ± SD, LD (mg/kg)	19.8 ± 3.3	20.8 ± 2.4
No. (%) patients receiving LD	61 (65)	51 (100)
Mean ± SD, MD (mg/kg)	13.1 ± 4.2	13.8 ± 4.5

Figure 1. Percentage of pre-IHD vancomycin levels, stratified by range.

Table 3. Percentage of pre-IHD vancomycin levels by weight range.

	Pre-protocol	Post-protocol	p Values
Weight <75 kg MD = 500 mg	N = 32	N = 21	–
10–14.9 mg/L	13	24	.28
15–20 mg/L	34	57	.1
>20 mg/L	50	19	.022
Weight 75–104.9 kg MD = 750 mg	N = 40	N = 21	–
10–14.9 mg/L	13	19	.49
15–20 mg/L	28	29	.92
>20 mg/L	58	52	.7
Weight 105–129.9 kg MD = 1000 mg	N = 17	N = 6	–
10–14.9 mg/L	18	17	.95
15–20 mg/L	18	17	.95
>20 mg/L	65	67	.9
Weight >130 kg MD = 1250 mg	N = 5	N = 3	–
10–14.9 mg/L	0	0	1
15–20 mg/L	20	0	.4
>20 mg/L	80	100	.4

Figure 2. Mean vancomycin pre-IHD level.

Table 4. Studies evaluating vancomycin dosing for IHD patients.

	No. of patients	Setting	Weight-based dosing	Results
Zelenitsky et al.^12	29	Outpatient^a	<70 kg: 1000 mg LD, 500 mg MD 70–100 kg: 1250 mg LD, 750 mg MD >100 kg: 1500 mg LD, 1000 mg MD	37.9% levels 15–20 mg/L
Panais et al.^13	38	Outpatient^a	20 mg/kg LD (capped at 1500 mg) 500 mg MD	82% levels 10–20 mg/L
Taylor and Allon^14	32	Inpatient^a	20 mg/kg LD 1000 mg MD	56% levels 10–20 mg/L
Lin et al.^15	69	Inpatient^b	15–20 mg/kg LD 500 mg MD	87% levels 15–20 mg/L

^aDose given during last hour of IHD.

^bDose given after IHD.

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