Treavor the Dose Whisperer

Step 1 Patient

Step 2 Regimen

Step 3 Levels

Step 4 Calculate

👤 Step 1 — Patient Characteristics IBW, CrCl, and BMI auto-calculate as you type

Age years

Biological Sex

Used for IBW and Cockcroft-Gault

Height inches

Weight (Actual) kg

Serum Creatinine ?Per Rybak 2020: use minimum SCr of 0.6 mg/dL for Cockcroft-Gault in patients with low muscle mass. Calculator enforces this floor automatically. mg/dL

ICU / Critically Ill? ?ICU status triggers: Roberts 2011 or Masich 2020 PK model, loading dose recommendation (25–30 mg/kg), and higher Vd population prior.

💊 Step 2 — Vancomycin Regimen Max dose 2000 mg per institution policy

Dose mg — capped at 2000 mg

750 mglow

1000 mgcommon

1250 mgcommon

1500 mgcommon

1750 mghigh

2000 mgmax

Interval

Infusion Time ?Standard: 1h for ≤1g, 1.5–2h for 1–2g, 3h for >2g. Slower infusions reduce Red Man Syndrome risk. hours

At Steady State? ?Steady state = after ≥3 doses. Required for accurate Sawchuk-Zaske first-order PK. Pre-SS levels work with Bayesian mode.

≤1000 mgOver 1 hour

1000–2000 mgOver 1.5–2 hours

Loading doseOver 1.5–2 hours

Loading Dose ?25–30 mg/kg TBW, max 3000 mg. Recommended for ICU patients or when rapid attainment needed. Based on expert opinion (Rybak 2020).

🔬 Step 3 — Levels & Calculation Method Bayesian recommended per Rybak 2020

Population PK Model ?Auto-selected by BMI and ICU status. Buelga=general; Roberts=ICU non-obese; Adane=extreme obesity; Masich=ICU+obese. Source: ClinCalc/Rybak 2020.

AUTO

Buelga 2005

General hospitalized patients

ICU

Roberts 2011

ICU / critically ill, BMI <30

OBESE

Adane 2015

Extreme obesity, BMI >40, wt ≥120 kg

ICU+OB

Masich 2020

ICU + obesity, BMI ≥30, wt >100 kg

Population PK estimates only. Consider drawing a peak + trough after the 3rd dose for patient-specific monitoring per Rybak 2020.

🎯 Step 4 — Targets & Calculate

MIC ?Use broth microdilution (BMD) MIC. Default 1.0 mg/L. If MIC ≥2, consider alternative therapy per Rybak 2020. mg/L

Target AUC₂₄ Low mg·h/L

Target AUC₂₄ High mg·h/L

References: Rybak MJ et al. AJHP 2020;77:835 · Buelga DS et al. AAC 2005;49:4934 · Roberts JA et al. AAC 2011;55:2704 · Adane ED et al. Pharmacotherapy 2015;35:127 · Masich AM et al. Pharmacotherapy 2020;40:211 · Matzke GR et al. AAC 1984;25:433

Results

📊 Complete patient info and regimen,
then press Calculate.