Batchelder et al reported a modified nomogram for dosing vancomycin in an obese adult. The authors are from Cone Memorial Hospital and High Point University in North Carolina.
Patient selection: body weight 100-299 kilograms, age >= 18 years
Exclusion: end-stage renal disease or continuous renal replacement therapy (CRRT)
Target: trough blood concentration: 10 to 20 micrograms per mL
Parameters:
(1) body weight in kilograms
(2) normalized creatinine clearance in mL/min
(3) age in years
Weight
Creatine Clearance
Age
Initial Dose
100 to 120 kg
< 30
NA
1500 mg q48h
30 to 59.9
NA
1250 mg q24h
60 to 90
NA
750 mg q12h
> 90
< 50 years
1000 mg q12h
> 90
>= 50 years
1000 mg q8h
120.01 to 140 kg
< 30
NA
1750 mg q48h
30 to 59.9
NA
1500 mg q24h
60 to 90
NA
1000 mg q12h
> 90
< 50 years
1250 mg q12h
> 90
>= 50 years
1250 mg q8h
> 140 kg
< 30
NA
2000 mg q48h
30 to 59.9
NA
1750 mg q24h
60 to 90
NA
1250 mg q12h
> 90
< 50 years
1500 mg q12h
> 90
>= 50 years
1500 mg q8h
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