vancomycin troughs (pre hemodialysis)

I'm hoping to get an idea of target vancomycin troughs (pre hemodialysis)that are being used and if they change based on the infection being treated. The general vancomycin guidelines used in our institutions have changed in the past year with trough targets dependant on infection (i.e. different if MRSA, endocarditis, CNS etc.) and I wonder if we should be doing the same. We've been using a general range of 7.5-15mg/L in our hemo patients - I think this should be higher, but exactly how high and if the targets should vary based on infection is leaving me stuck. I've found little in the literature addressing this question, but I'm still working through it.
I hope this will start some discussion, thanks!
Andrea Woodland (St. John's)
andrea.woodland@easternhealth.ca