What is the target AUC/MIC for vancomycin?

The 2020 ASHP/IDSA/SIDP consensus guidelines recommend an AUC/MIC target of 400–600 mg·h/L for serious MRSA infections, assuming an MIC of 1 mg/L by broth microdilution. This replaces the older trough-only target of 15–20 mg/L.

Why two levels instead of one trough?

Two timed levels (peak and a later level, or any two post-dose levels) allow direct calculation of the patient-specific elimination rate constant (Ke) and volume of distribution (Vd), enabling accurate AUC estimation without relying solely on population-average parameters.

What body weight should I use?

Enter the patient's actual body weight (ABW) in kilograms. For obese patients (BMI > 40), many clinicians use a pharmacokinetic dosing weight; consult your institutional protocol. This calculator uses ABW as entered.

Is this calculator a substitute for clinical judgment?

No. This tool is for educational and decision-support purposes only. All dosing decisions must be reviewed and approved by a licensed clinical pharmacist or physician who can account for the full clinical picture, including drug interactions and changing renal function.

What infusion duration is assumed?

Standard 1-hour infusions are assumed. If extended infusions (e.g., 2–3 h) are used, the peak collection time should be adjusted accordingly. The infusion duration field lets you enter the actual value used.

How is creatinine clearance estimated?

Creatinine clearance (CrCl) is estimated with the Cockcroft-Gault equation using the entered age, sex, weight, and serum creatinine. The result drives the population-based Vd and is displayed for verification.

Vancomycin AUC Dosing Calculator

Calculate vancomycin AUC/MIC ratio and individualized dose using two-level Bayesian pharmacokinetics per the 2020 ASHP/IDSA consensus guidelines.

Patient & Dose Parameters

Weight (kg)

Age (years)

Sex

Serum Creatinine (mg/dL)

Current Dose

Dose (mg)

Interval (h)

Infusion Duration (h)

Measured Serum Levels

Level 1 — C1 (mg/L)

Time of C1 post-dose start (h)

Level 2 — C2 (mg/L)

Time of C2 post-dose start (h)

Fill in patient parameters and two serum levels,
then click Calculate AUC.

Estimated AUC24/MIC

—

mg·h/L (MIC = 1 mg/L assumed)

0Target: 400–600800+

Individual PK Parameters

CrCl (Cockcroft-Gault)

—

mL/min

Elimination Ke

—

h^-1

Half-life (t½)

—

hours

Volume of Distribution

—

Clearance (CL)

—

L/h

Steady-state Cmin (est.)

—

mg/L

Dose Recommendation to Target AUC 400–600

Suggested Dose

—

mg per dose

Suggested Interval

—

hours

Clinical decision support only. All dosing recommendations must be reviewed by a licensed pharmacist or physician. Verify levels, renal function, and institutional protocols before adjusting therapy.

Summary

This calculator applies the 2020 ASHP/IDSA/SIDP vancomycin consensus guidelines, which replaced trough-only monitoring with AUC/MIC-guided dosing. Enter patient demographics, renal function, and two timed serum vancomycin levels to estimate individual PK parameters (Ke, Vd, CL), compute the 24-hour AUC, and receive a recommended dose and interval to achieve the target AUC/MIC of 400–600 mg·h/L (assuming MIC = 1 mg/L). Intended as a clinical decision-support aid; all results must be verified by a licensed pharmacist or physician.

How it works

Enter patient weight (actual body weight), age, sex, and serum creatinine.
Input the first vancomycin level (C1) and its collection time post-infusion start, then the second level (C2) and its time.
The calculator estimates the elimination rate constant (Ke) from the two measured levels.
Using Ke, infusion details, and population Vd, it computes peak (Cmax), trough (Cmin), clearance (CL), and volume of distribution (Vd).
AUC24 is derived via the trapezoidal method over one dosing interval then scaled to 24 hours.
A suggested new dose and interval are calculated to hit an AUC/MIC of 400–600 assuming MIC = 1 mg/L.

Use cases

Pharmacist-guided vancomycin AUC monitoring for MRSA bacteremia.
Optimizing vancomycin therapy in patients with changing renal function.
Calculating individual PK parameters after two measured serum levels.
Teaching clinical pharmacokinetics and AUC-guided dosing concepts.
Rapid bedside estimation when a full Bayesian software suite is unavailable.
Confirming pharmacy recommendations during clinical rounds.
Documenting AUC/MIC ratio for antimicrobial stewardship records.

Frequently Asked Questions

Last updated: 2026-09-30 · Reviewed by Nham Vu