Pharmacokinetics · TDM

Vancomycin Calculator

Empiric Dosing + AUC₂₄ Monitoring

2020 ASHP/IDSA/PIDS/SIDP Consensus Guidelines · Rybak MJ, et al. AJHP 2020;77:835–864

How to use. Results are calculated automatically once all patient fields below are filled in. Changing options like sex, infection severity, or target AUC updates the result immediately.

Initial Empiric DoseEmpiric Dosing

AUC MonitoringTrough-based AUC₂₄

Patient Information

Sex

Male Female

Age

years

Weight — actual

Height

Serum Creatinine

mg/dL

Infection Indication · Target

Infection Severity

Standard InfectionSSTI, UTI, etc. Severe / MRSABacteremia, endocarditis, osteomyelitis, CNS

Recommended Dose

Fill in all patient fields to see the recommended dose automatically.

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Loading Dose

— mg

—

Maintenance

— mg

—

Clinical Recommendation

Current Regimen · Measured Level

Dose per Administration

Dosing Interval

Measured Trough — steady state

mg/L

Target AUC₂₄

400–600 400–500

AUC₂₄ Result

Fill in patient info + current regimen + measured trough to calculate the result automatically.

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— mg·h/L

Dose Adjustment Recommendation

Vancomycin Monitoring Essentials (2020 ASHP/IDSA)

AUC-based monitoring is now standard — the 2020 guideline moved away from trough-only monitoring (15–20) to AUC₂₄ 400–600 mg·h/L. AUC-guided dosing lowers the rate of nephrotoxicity.
Loading dose — for severe MRSA infections, 25–35 mg/kg × actual body weight is recommended (max 3,000 mg). Infuse at ≤1 g/hour to prevent red-man syndrome.
Maintenance dose — 15–20 mg/kg/dose, interval 8–24h depending on renal function. Max 2,000 mg per dose.
Obese patients (BMI ≥ 30) — both loading and maintenance are based on actual BW, but capped at 2 g per dose; some institutions cap total daily dose at ≤4.5 g/day.
Trough timing — ideally just before the 4th dose (steady state); this page can also estimate under a first-order PK assumption.
Nephrotoxicity risk — sustained AUC₂₄ > 600 or trough > 15–20 mg/L increases AKI risk. Use extra caution with concomitant piperacillin-tazobactam, contrast media, NSAIDs, or loop diuretics.
Limitations of this calculator — estimates are based on a population PK (1-compartment) model. Accuracy is reduced in AKI, pregnancy, burns, and dialysis patients; Bayesian software (e.g., PrecisePK, DoseMeRx) is more accurate.