I just got finished telling off a whole group of medical providers (PA, MD, RN) for vanco dosing. 58yo F on HD comes to the ER for a fever. ER orders vanco 2g loading dose for sepsis, with bcx drawn prior to admin. Unnecessary to go straight for vanco, but okay fine. MRSA nasal neg. Bcx biofire comes back as staph, no mec detected. Patient gets admitted for bcx+ with permacath. Admitting doc orders vanco 2g q12h overriding warnings for 1) daily dose >3g requires ID consult daily dose is <3g . 2) dose is >100% of the recommended dose based on renal function ER said she needed vanco . 3) vanco requires monitoring levels, please order level no level needed and then nurse arguing she needed the dose now... 6hrs after the loading dose. Then the PA telling me the dose seems fine, she needs to get her antibiotics. Then the admitting doc telling me the ER says she needs it. At which point I got pissy and told them off and refused to verify or dispense the vanco. Recommended ancef post HD.…