Abstract
Vancomycin is one of the first choices for treating serious infections caused by gram-positive bacteria. To manage its efficacy and toxicity, therapeutic drug monitoring is recommended and routinely conducted.
However, the initial maintenance dose (MD) must be determined based on the estimated clearance. Previous studies have found linear relationship between vancomycin clearance (CL-VAN) and creatinine clearance (CL-CR) estimated by Cockcroft-Gault (C-G) and Modification of Diet in Renal Disease (MDRD) formulas.
There is only a very limited knowledge on the relationship between CL-VAN and an up-to-date method for CL-CR calculation-Chronic Kidney Disease Epidemiology Collaboration (CKDEPI). A few nomograms for continuous vancomycin initial MD based on C-G or MDRD6 have been published, but no nomogram based on CKD-EPI is available.
To clarify the possibility to predict CL-VAN, we compared the performance of 4 well-known equations for CL-CR estimation, that is, CKD-EPI, MDRD, C-G, and Jelliffe, and then we propose an initial MD estimate based on the best correlating equation in adult intensive care unit patients treated with vancomycin continuous infusion.