Vancomyzer: vancomycin AUC calculator for adults.
Estimate a starting regimen or use measured levels to compare dosing options. Targets follow the 2020 ASHP/IDSA/PIDS/SIDP consensus guideline. Review the model assumptions and limitations before using an estimate.
Adults receiving intermittent IV vancomycin only. For clinician review. Independent clinical validation is pending.
Access to Vancomyzer is currently free.
Your first Vancomyzer walkthrough
Learn how Bayesian estimation works, then follow a fictional adult example through the calculator. Review patient inputs, loading doses when appropriate, estimated exposure, and calculation details.
Read the tutorial summary
Welcome to the Vancomyzer tutorial. Learn about Bayesian estimation through a navigation app analogy, then explore the calculator using fictional patient inputs.
Review the patient information and dosing history before calculating. Before considering a loading dose, always check for recent doses given at this facility and at any other facility the patient visited.
When a loading dose is appropriate, review the recommended amount and infusion duration. The calculator uses a maximum infusion rate of 10 mg per minute and a minimum duration of 60 minutes. A 2000 mg dose therefore requires at least 200 minutes.
Review the estimated exposure and calculation details. Predictions are model estimates, not measured patient values. Use clinical judgment, institutional protocols, and therapeutic drug monitoring. Independent clinical validation is pending.
1 · Patient
Age, weight, height, serum creatinine and renal replacement status. Estimated creatinine clearance is shown for context; the dose is calculated from serum creatinine as the Colin 2019 model input.
2 · Recommendation
Dose, interval and infusion duration. AUC₂₄ is compared with the 400–600 mg·h/L target; peak and trough are reported separately. Relevant cautions appear below the recommendation.
3 · Alternatives and calculation details
Other regimens computed from the same parameters, the four PK parameters, the method, and a note you can copy into the chart.
What a starting-regimen comparison looks like
The table is produced by the same calculation method as the application for a stated set of synthetic inputs. It is an illustration of the output, not evidence of clinical validation, and the regimens are not for use with a patient.
Age 55 · male · 70 kg · 170 cm
Serum creatinine 1 mg/dL · no measured levels
Starting-regimen comparisons from the current calculator:
| Regimen | AUC₂₄ mg·h/L | Peak mg/L | Trough mg/L |
|---|---|---|---|
| 500 mg every 8 h Infused over 1.00 h | 526 | 27.6 | 17.6 |
| 750 mg every 12 h Infused over 1.25 h | 526 | 31.1 | 15.9 |
| 1500 mg every 24 h Infused over 2.50 h | 526 | 41.3 | 12.6 |
Population-model estimates at steady state, without level-based adjustment. The same daily dose gives the same AUC₂₄; peak and trough are what change. This is a synthetic example, not a patient or evidence of clinical validation. Do not use these regimens for a patient.
From the first dose to level-guided adjustment
- AUC₂₄-guided targets
- Suggested regimens aim for an AUC₂₄ of 400–600 mg·h/L, the target range recommended for serious MRSA infections (assuming an MIC of 1 mg/L) by the 2020 ASHP/IDSA/PIDS/SIDP vancomycin consensus guideline.Rybak MJ et al. Am J Health Syst Pharm. 2020;77(11):835-864.
- Empiric dosing from patient characteristics
- Before any levels are available, get a suggested starting regimen, including loading-dose guidance, based on age, weight, serum creatinine and other patient characteristics.
- Refinement with one or two levels
- Enter one or two measured vancomycin levels and the estimate is individualized to your patient with Bayesian methods. The adjustment is bounded, so one unusual level cannot override the population data.
- Colin 2019 pooled population model
- A published, peer-reviewed analysis that pools 14 vancomycin studies. Vancomyzer shows the model, assumptions and evidence behind each estimate.Colin PJ, et al. Vancomycin pharmacokinetics throughout life: results from a pooled population analysis and evaluation of current dosing recommendations. Clin Pharmacokinet. 2019;58(6):767-780.
- One model for all adults, with a high-BMI advisory
- Colin 2019 is used for every adult, at every body size. At a BMI of 40 kg/m² or higher, an advisory notes that published evaluation at that size is limited, and fat-free mass and alternative creatinine-clearance estimates are shown for context only. They do not change the calculation.Colin PJ, et al. Ther Drug Monit. 2021;43(1):126-130. PMID: 33278242.
- Built-in safety checks
- Infusions are kept to a maximum rate of 10 mg/min and at least 60 minutes. Recommendations are withheld for dialysis or renal replacement therapy, and warnings flag severely reduced kidney function, questionable level timing and a poor fit to measured levels.
Review the evidence before you rely on it
The pages below document the model equations, assumptions, sources, results and limitations. Vancomyzer has not yet been validated in real patients; published model evidence and developer-run checks are not independent clinical validation.
| Item | What it covers | Status |
|---|---|---|
| Population model | Colin 2019 two-compartment model; population equations and references, with the assumptions used to adjust estimates to measured levels | Published |
| Literature reproducibility | Selected published population values compared with calculator estimates | Developer-run |
| Predictive performance | Predictions checked in simulated ICU patients using a model adapted from published research | Developer-run |
| Comparison with Tucuxi | Estimates compared with Tucuxi in simulated patients, using limits set before the analysis | Developer-run |
| Software checks | Independent reference calculation (including loading-dose schedules) and synthetic coverage of the 90% uncertainty band | Developer-run |
| Independent clinical validation | Study with patient data at a participating institution | Pending |
| FDA review | Designed to meet non-device CDS criteria, FD&C §520(o)(1)(E); not reviewed by the FDA | Not reviewed |
Designed for
Adults (18 years and older) receiving intermittent intravenous vancomycin.
- Pharmacists
- Physicians
- Nurse practitioners
- Physician assistants
- Residents
- Students
Intended for qualified healthcare professionals and clinical trainees. Every recommendation must be independently reviewed by a licensed clinician before any change to therapy. Not intended for patients or caregivers.
Not designed for
- Pediatric patients
- Patients on dialysis or other renal replacement therapy
- Continuous-infusion vancomycin
Recommendations are withheld when renal replacement therapy is selected. Continuous infusion and pediatric dosing use different models and are out of scope.
Free access
Vancomyzer™ is designed to meet the criteria for non-device clinical decision support in section 520(o)(1)(E) of the Federal Food, Drug, and Cosmetic Act (added by section 3060 of the 21st Century Cures Act). It has not been cleared, approved or otherwise reviewed by the FDA. It is intended for licensed healthcare professionals, who must independently review the basis for each recommendation. It supports, and does not replace, clinical judgment: review every recommendation against the patient’s clinical status, institutional protocols and therapeutic drug monitoring before any change to therapy.
Read the full medical disclaimer