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Neonatal vancomycin target trough levels are not always achieved, thus increasing the risk of morbidity and mortality due to treatment failure. The British National Formulary for Children (BNFc) dosing guidance is widely used despite there being no evidence of it achieving target trough levels.1 Within the UK, Kadambari et al 1 found that 79% of surveyed neonatal units use the BNFc vancomycin dosing. In 2007, the BNFc changed the target trough recommendations from 5–10 mg/L to 10–15 mg/L due to increasing resistance, but did not change the dosage recommendations.1 Neonates are potentially being under-dosed after 2007. The BNFc dosing is based on corrected gestational age (CGA) and weight, with the dosing being 15 mg/kg …
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