In patients undergoing intermittent hemodialysis:
20 mg/kg IV x 1 dose (using most recent post-dialysis weight, rounded to the nearest 250 mg)
Max loading dose = 2g
500 mg IV near the end of dialysis
750 mg IV near the end of dialysis
1g IV near the end of dialysis
Target Pre-Dialysis Vancomycin Levels:
Pre-dialysis level < 10 mg/L:
Pre-dialysis level 10 – 20 mg/L:
Pre-dialysis level > 20 – 25 mg/L:
Pre-dialysis level > 25: