At DoseMe, we've implemented a range of vancomycin models to help you optimize therapy for a wide range of patient cohorts.
Vancomycin dosing in hemodialysis patients using DoseMeRx
The hemodialysis, two-compartment vancomycin adult model available in DoseMeRx is derived from the Goti et al retrospective study which included 336 patients on hemodialysis. It has been developed for use in patients receiving high-flux, intermittent hemodialysis. The study concluded that clearance in patients undergoing hemodialysis was 35% lower than clearance in nondialysis patients, and the volume of distribution was approximately halved in dialysis patients when compared to nondialysis patients. Thus, the DoseMeRx hemodialysis model has been built considering these parameters to ensure more appropriate loading and maintenance dose recommendations are provided for this population.
How can I dose hemodialysis patients in DoseMeRx?
Dosing to trough is the primary dosing target in this population as AUC targets in hemodialysis are less well established. At the time of writing, the draft IDSA vancomycin guidelines discuss this further, and DoseMe will continue to monitor developments.