Version August 2025
| Drug | Adult dose |
| Antibiotics of choice | |
| Vancomycin[1] | Loading dose*: 20 to 35 mg/kg Initial maintenance dose and interval determined by nomogram¶; typically 15 to 20 mg/kg every 8 to 12 hours for most patients with normal kidney function Subsequent dose and interval adjustments based on AUC-guided (preferred) or trough-guided serum concentration monitoringΔ |
| Daptomycin[2,3] | 8 to 10 mg/kg IV once daily◊ |
| Teicoplanin (not available in the United States) | Loading dose: 6 to 12 mg/kg IV every 12 hours for 3 to 5 doses Maintenance dose: 6 to 12 mg/kg IV once daily; may adjust to ensure targeted trough concentrations |
| Alternative agents§ | |
| Short-acting agents | |
| Ceftaroline | 600 mg IV every 8 hours |
| Ceftobiprole¥ | 500 mg IV every 6 hours for 8 days, and every 8 hours thereafter |
| Telavancin | 10 mg/kg IV once daily |
| Linezolid | 600 mg IV (or orally) every 12 hours |
| Tedizolid | 200 mg IV (or orally) once daily |
| Long-acting agents | |
| Dalbavancin | 1000 mg as single dose, followed by 500 mg dose one week later |
| Oritavancin | 1200 mg once weekly |
AUC: area under the 24-hour time-concentration curve; IV: intravenously.
* The vancomycin loading dose is based on actual body weight, rounded to the nearest 250 mg increment, and not exceeding 3000 mg. Within this range, we use a higher dose for critically ill patients.
¶ Refer to the UpToDate topic on vancomycin dosing for sample nomogram.
Δ Refer to the UpToDate topic on vancomycin dosing for discussion of AUC-guided and trough-guided vancomycin dosing.
◊ Daptomycin dosing for treatment of bacteremia (as approved by the US Food and Drug Administration) is 6 mg/kg IV once daily; however, because daptomycin exhibits concentration-dependent killing, we favor higher dosing of 8 to 10 mg/kg IV once daily.
§ Refer to UpToDate content for clinical circumstances that may warrant use of a combination regimen.
¥ Dosing regimen in the table differs from approved dosing in Canada and Europe; patients with bacteremia associated with pneumonia were excluded from clinical trial[4].