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Vancomycin Dosing Severe CKD — SCE Infectious Diseases MCQ

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HardAntimicrobial StewardshipVancomycin Dosing Severe CKDSCE Infectious Diseases

A haemodialysis patient with MRSA bacteraemia receives an appropriate vancomycin loading dose. Which maintenance principle is safest?

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Correct answer: B — Individualise post-dialysis redosing using timed concentrations or AUC-informed monitoring and the dialysis schedule

The best answer is “Individualise post-dialysis redosing using timed concentrations or AUC-informed monitoring and the dialysis schedule”. Maintenance vancomycin in haemodialysis must be individualised using the dialysis schedule and timed serum concentrations or AUC-informed monitoring. Fixed 1 g 12-hourly dosing risks serious accumulation or underexposure. Oral vancomycin does not treat bacteraemia, and a weight-based loading dose does not remove the need for maintenance monitoring.

Reference: Vancomycin 500 mg SmPC: https://www.medicines.org.uk/emc/product/8759/smpc