Half-Life of Vancomycin in Patients with Normal Kidney Function

The mean elimination half-life of vancomycin from plasma is 4 to 6 hours in patients with normal renal function. 1

Pharmacokinetic Properties of Vancomycin

Vancomycin is primarily eliminated through glomerular filtration, with approximately 75% of an administered dose excreted in urine within the first 24 hours in patients with normal renal function 1
Mean plasma clearance of vancomycin is approximately 0.058 L/kg/h, while mean renal clearance is about 0.048 L/kg/h 1
Vancomycin is approximately 55% serum protein bound at concentrations of 10-100 mcg/mL 1
The distribution coefficient of vancomycin ranges from 0.3 to 0.43 L/kg 1
There is no apparent metabolism of vancomycin in the body 1

A study in healthy volunteers with normal renal function found that vancomycin disposition is best described by a three-compartment model with a terminal half-life of 7.7 ± 1.8 hours 2
In critically ill patients with normal renal function (creatinine clearance >1 mL/min/kg), the mean plasma elimination half-life was found to be 7.8 ± 2.8 hours, which is slightly longer than in healthy individuals 3
The half-life is significantly prolonged in patients with renal dysfunction, increasing to approximately 18.3 ± 10.2 hours in patients with severely reduced renal function (creatinine clearance ≤1 mL/min/kg) 3

For patients with normal renal function, vancomycin dosages of 15-20 mg/kg (based on actual body weight) given every 8-12 hours are typically required to achieve target trough serum concentrations when the MIC is ≤1 mg/L 4
When administering individual doses exceeding 1 g (e.g., 1.5 and 2 g), the infusion period should be extended to 1.5-2 hours to minimize infusion-related adverse effects 4
In patients with normal renal function, significant accumulation occurs with multiple dosing, which should be considered when designing dosing regimens 2

Vancomycin clearance is highly correlated with creatinine clearance (r = 0.92), making renal function the primary determinant of vancomycin elimination 5
Monitoring trough serum vancomycin concentrations is recommended for patients receiving aggressive dosing targeting trough concentrations of 15-20 mg/L or who are at risk of toxicity 4
The concentration of vancomycin in renal tubules can be approximately 40-50 times higher than that in plasma, which may contribute to nephrotoxicity risk 6
Individual pharmacokinetic adjustments and verification of target serum concentrations are recommended due to interpatient variability in vancomycin clearance, even among patients with similar creatinine clearance values 3

For most patients receiving vancomycin, at least one steady-state trough serum concentration should be measured just before the fourth dose 4
Frequent monitoring is particularly important for patients receiving prolonged courses of therapy or those with unstable renal function 4
Target trough concentrations of 15-20 mg/L are recommended for serious infections such as bacteremia, endocarditis, osteomyelitis, meningitis, and hospital-acquired pneumonia caused by S. aureus 4