A 55-year-old man on ICU has septic shock and is receiving IV vancomycin for MRSA bacteraemia. He also has AKI requiring CRRT. The pharmacist recommen...

Question

A 55-year-old man on ICU has septic shock and is receiving IV vancomycin for MRSA bacteraemia. He also has AKI requiring CRRT. The pharmacist recommends a vancomycin loading dose before starting maintenance dosing. Why is a loading dose important in critically ill patients?

Accepted Answer

Critically ill patients often have an increased volume of distribution (Vd) from capillary leak, fluid resuscitation, and oedema - a loading dose rapidly achieves therapeutic drug levels in this expanded Vd, preventing subtherapeutic levels during the critical early hours of treatment when bacterial killing is most important

Answer

Loading doses are never important

Answer

Loading doses are only needed for oral medications

Answer

Loading doses are dangerous and should be avoided

Answer

CRRT eliminates the need for a loading dose

uk-fficm MCQ (SBA): Loading Dose in Critical Illness

A 55-year-old man on ICU has septic shock and is receiving IV vancomycin for MRSA bacteraemia. He also has AKI requiring CRRT. The pharmacist recommends a vancomycin loading dose before starting maintenance dosing. Why is a loading dose important in critically ill patients?