Why has trough-only monitoring been replaced by AUC monitoring?

Trough-only monitoring does not accurately predict AUC24/MIC, particularly in patients with altered Vd. High troughs required to ensure AUC adequacy caused excess nephrotoxicity in the trough-only era.

In what situations might trough monitoring still be used?

Trough monitoring may remain practical when two-sample AUC methods are logistically challenging, in stable outpatients with predictable kinetics, or in institutions that have not yet transitioned to Bayesian software-assisted AUC monitoring.

Vancomycin Trough-Based Dosing Nomogram

Use vancomycin trough-based dosing nomogram to adjust dose and interval based on measured trough concentrations, acknowledging limitations compared to AUC-guided monitoring per 2020 consensus guidelines.

Use the full interactive calculator below, or

Vancomycin Trough-Based Dosing Nomogram

Frequently Asked Questions

Why has trough-only monitoring been replaced by AUC monitoring?

In what situations might trough monitoring still be used?