Vancomycin dosing in low-flux hemodialysis; is adjustment of drug dosage necessary?

Introduction: vancomycin is a wide useable antibiotic against gram-positive bacteria speciesin different clinical setting particularly in hemodialysis patients.objectives: the present study aimed to assess the serum level of vancomycin before and afterhemodialysis.patients and methods: this cross-sectional study was performed on patients who werehospitalized and medicated by vancomycin with the loading dose of 1000 mg followed bythe maintenance dose of 500 mg after each dialysis session every other day. all patientswere dialyzed with a low-flux dialyzer membrane. half an hour before and immediatelyafter dialysis, 2 ml blood sample was taken and stored at -20°c until assaying the level ofvancomycin.results: the average reduction in the serum level of vancomycin was totally 17.65 ± 1.69%.the mean reduction in the serum level of vancomycin was significantly higher in the patientsaged higher than 60 years, as compared to other ones. but the level of drug was independentto gender or body mass index.conclusion: using low-flux dialyzer membranes, the average reduction in the serum level ofvancomycin is expected to be in the range of 12.43% to 21.56% that age was directly associatedwith the average reduction of the level of vancomycin. therefore, adjusting and monitoringthe serum level of drug in old ages even in the cases of using low-flux dialyzer membranes isrecommended.