The recommended intravenous dosage in adults is 500 mg iv every 6 hours or 1000 mg every 12 hours, with modification to achieve a therapeutic range as needed. The recommended oral dosage in the treatment of antibiotic-induced pseudomembranous enterocolitis is 125 to 500 mg every 6 hours for 7 to 10 days.
Dose optimization and target attainment of vancomycin in children involves adjusting the dosage of the antibiotic to maximize its effectiveness while minimizing the risk of adverse effects, specifically acute kidney injury. Dose optimization is achieved through therapeutic drug monitoring (TDM), which allows to measure vancomycin levels in the blood and tailor the dosage accordingly. TDM using area under the curve (AUC)-guided dosing, preferably with Bayesian forecasting, is recommended to ensure that the AUC0-24h/minimal inhibitory concentration (MIC) ratio is maintained above a certain threshold (400-600) associated with optimal efficacy.