Pharmacists,

The CVSURG and CTSURG powerplans have been updated to include a once "Consult to Pharmacy" for renal adjustment of the vancomycin dose. Because it is a one time consult, there is no need to write a note. Dosing recommendations are based off estimated creatinine clearance and can be found in the comment of the consult. Those recommendations are not meant to replace clinical judgement (ex: if you have an elderly patient who has an estimated CrCl of 65 ml/min, I would personally change to q24h instead of the recommended q12h). 

Also, other antibiotics will include a comment that allow for renal adjustment as well. Please follow specific directions in the comments of the order for each powerplan. Let me know if you have any questions. Thanks!