Renal dosing - GFR v CrCl

[bingbongbink]

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Did a quick search, nothing popped up.

So if im dosing vancomycin, do I use the GFR or CrCl? I have been calculating the CrCl and dosing based on that.

 

[Nivakia]

Yeah I thought CrCl

 

[bingbongbink]

for some reason the ID fellow asked me about GFR when I asked for approval for vancomycin... and then she said give q12h... but when I calculated it with the CrCl the dosing came out to 1g q24

 

[Nivakia]

Yeah there is definitely a controversy on this. CrCl seems to be done by the pharmacist where I work while the renal and ID ppl use GFR.

 

[gutonc]

"Vancomycin. Pharmacy to dose. Indication: X"

Then I go do something useful with my day.

 

[Raryn]

"Vancomycin. Pharmacy to dose. Indication: X"

Then I go do something useful with my day.

Some residency programs (well... one at least. mine.) don't allow it. It's really dumb, because the way it usually works is one of our residents just puts in a random !@#$ing dose of vanco, knowing the pharmacy will call within 5 minutes with a "suggestion" on how to fix it. I at least try to eyeball the weight, age, and creatinine/gfr before I dose it... but even then am only right maybe 2/3 of the time.

 

[obiwan]

"Vancomycin. Pharmacy to dose. Indication: X"

Then I go do something useful with my day.

Yep, the most used order in our EMR

 

[chessknt]

Same here. My favorite call from some socially inept VA pharmacist was: "So, um, did you want this to be therapeutic?" No bro, I just wanted to use vancomycin because it's so fun to dose wrong every time myself!