Renal dosing - GFR v CrCl

Discussion in 'Internal Medicine and IM Subspecialties' started by acdu1411, Aug 2, 2015.

  1. acdu1411

    7+ Year Member

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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.
     
  2. Nivakia

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    Yeah I thought CrCl
     
  3. acdu1411

    7+ Year Member

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    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
     
  4. Nivakia

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    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.
     
  5. gutonc

    gutonc No Meat, No Treat
    Administrator Physician PhD 10+ Year Member

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    "Vancomycin. Pharmacy to dose. Indication: X"

    Then I go do something useful with my day.
     
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  6. Raryn

    Raryn Infernal Internist / Enigmatic Endocrinologist
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    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 [email protected]#$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.
     
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  7. obiwan

    obiwan Junior Member
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    Yep, the most used order in our EMR
     
  8. chessknt87

    Physician 10+ Year Member

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    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!
     
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