# Vancomycin Pharmacokinetics and Pharmacodynamics

## Questions provided by Michele Splinter, Pharm.D.

You are asked to start vancomycin therapy in a patient who has pneumonia secondary to penicillin and cephalosporin resistant *Streptococcus pneumoniae*.

**Patient characteristics**Age: 66 yr | Gender: male | Weight: 51.4 kg | ht: 73 in |

Scr: 1.82 mg/dL | Organism MIC 0.5 mg/L |

A. Using the following population based estimates for vancomycin:

Vancomycin kel (hr^{-1}) = 0.0044 + 0.00083 * (CLcr in mL/min)

Vancomycin Vd = 0.7 L/Kg * (Total Body Weight in Kg)

Calculate kel, t_{1/2}, Vd, CL.

B. Use the calculated patient parameters to determine a dosing interval (to the nearest 12 hr), infusion duration (to the nearest 15 minutes) and maintenance dose (to the nearest 250 mg) to produce a Cp_{max}^{ss} of 60 mg/L and a Cp_{min}^{ss} of 20 mg/L. Calculate the projected Cp_{max}^{ss} and Cp_{min}^{ss} on the new regimen.

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**Some Equations:**

Equation 27.5.1 IBW for Male Patients

Equation 27.5.2 IBW for Female Patients

Equation 27.5.3 Creatinine Clearance (Cockcroft-Gault Equation)

Equation 27.5.5 Dosing Interval, τ

Equation 27.5.6 Maintenance Dose

Last update: Sat 27 Apr 2019 09:41:40 pm

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