Assessment of initial serum vancomycin trough concentrations and their association with initial empirical weight-based vancomycin dosing and development of nephrotoxicity in children: a multicenter retrospective study

Pharmacotherapy
Kelly L MatsonKari A Simonsen

Abstract

To determine whether a relationship exists between initial serum vancomycin trough concentrations and initial empirical vancomycin dose, patient weight, and patient age, and to determine the risks for vancomycin-associated nephrotoxicity in pediatric patients stratified by hospital setting. Stepwise linear and multinomial logistic regression analysis of retrospectively collected data. Two geographically distinct children's tertiary care medical centers. A total of 316 pediatric patients without preexisting renal dysfunction who were managed outside of the neonatal intensive care unit and were treated with at least 3 doses of vancomycin for gram-positive bacterial infections and had at least one serum vancomycin trough concentration between January 1, 2008, and July 31, 2010. Elevated vancomycin trough concentrations had no statistically significant relationship with initial empirical vancomycin dosing across all hospital settings. Serum vancomycin trough concentrations (lower than 15 mg/L or 15-20 mg/L) were not associated with increased risk of nephrotoxicity. Concomitant nephrotoxic agents, however, including loop diuretics, vasopressors, angiotensin-converting enzyme (ACE) inhibitors, and nonsteroidal antiinflammatory drugs ...Continue Reading

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Jul 15, 2015·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Mo-Han DongAi-Dong Wen
Jun 14, 2016·Therapeutic Advances in Endocrinology and Metabolism·Oluwatoyin Bamgbola
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Jun 10, 2021·Clinical Interventions in Aging·Yunchao WangChunyan Jiang
Oct 15, 2021·Hospital Pediatrics·Manaswitha KhareByron A Foster

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