Vancomycin is commonly under-dosed in critically ill children and neonates

British Journal of Clinical Pharmacology
Natasha SosninAmanda Gwee

Abstract

Vancomycin is frequently used in critically ill children in whom the drug pharmacokinetics are significantly altered as a result of changes in renal clearance and volume of distribution. Therapeutic drug monitoring (TDM) is recommended to achieve vancomycin trough concentrations between 10 and 20 mg/L. In this study we reviewed vancomycin dosing, TDM and treatment outcomes in paediatric and neonatal intensive care unit patients. We reviewed the medical records of all patients receiving intravenous vancomycin in a tertiary paediatric and neonatal intensive care unit over a 10-month period. Demographic, vancomycin dosing, TDM and drug-related adverse effects data were collected. In total, 115 children received 126 courses of vancomycin and had at least 1 TDM blood sample taken at steady state. In only 38/126 (30%) courses was the target concentration (10-20 mg/L) achieved at the initial steady state trough sample. Of the 88 courses that had initial trough concentrations outside the target range, the dose was adjusted in only 49 (56%). Overall, minimum doses of 30 mg/kg/day in neonates with a corrected gestational age of <35 weeks, and 50 mg/kg/day in older children, were required to achieve target vancomycin concentrations. Vanco...Continue Reading

References

Aug 1, 1981·Clinical Pharmacology and Therapeutics·C A NaranjoD J Greenblatt
Sep 1, 1993·The Pediatric Infectious Disease Journal·D M KrausS A Kecskes
Oct 26, 1999·The Annals of Pharmacotherapy·R S EvansJ P Burke
Oct 12, 2000·Archives of Internal Medicine·J M TeichD W Bates
Sep 19, 2003·The New England Journal of Medicine·Gregory L KearnsRalph E Kauffman
Sep 9, 2006·Journal of Clinical Pharmacy and Therapeutics·P Llopis-Salvia, N V Jiménez-Torres
Dec 25, 2008·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Michael RybakDonald P Levine
Jan 14, 2009·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Trey CrumbyAjay J Talati
Feb 25, 2009·Critical Care Medicine·Jason A Roberts, Jeffrey Lipman
Jan 11, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Catherine LiuHenry F Chambers
Mar 8, 2011·Archives of Disease in Childhood. Fetal and Neonatal Edition·C OudinN Simon
Mar 25, 2011·International Journal of Clinical Pharmacology and Therapeutics·E F BadranY M Irshaid
Mar 14, 2012·European Journal of Clinical Pharmacology·Sepideh ElyasiAmirhooshang Mohammadpour
Jun 15, 2012·The Journal of Trauma and Acute Care Surgery·Lori F GentileFrederick A Moore
Jul 4, 2012·Annals of Intensive Care·Bruno Van HerendaelMargareta Ieven
Jan 22, 2013·Antimicrobial Agents and Chemotherapy·Natasha E HolmesPaul D R Johnson
Jan 24, 2013·The Pediatric Infectious Disease Journal·Jennifer LeEdmund V Capparelli
Mar 2, 2013·Critical Care : the Official Journal of the Critical Care Forum·Andrew A UdyJeffrey Lipman
Mar 13, 2014·Antimicrobial Agents and Chemotherapy·Julianne KimAndrew Simor
Jun 10, 2014·Advanced Drug Delivery Reviews·Manjunath P PaiThomas P Lodise
Mar 1, 2012·Kidney International Supplements
Sep 30, 2014·Journal of Clinical Pharmacology·Alfred H BalchCatherine M T Sherwin
Dec 3, 2014·The American Journal of Emergency Medicine·A Brad HallTim Regan
Jan 30, 2015·The Pediatric Infectious Disease Journal·Theresa RingenbergMarc Sturgill
Jul 4, 2015·Clinical Pharmacokinetics·Frederique RodieuxMarc Pfister
Sep 25, 2015·Archives of Disease in Childhood. Fetal and Neonatal Edition·Jonathan E ConstanceMichael G Spigarelli
Feb 19, 2016·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Jeffrey J CiesArun Chopra
Apr 14, 2016·Critical Care Research and Practice·Bita ShahramiMojtaba Mojtahedzadeh
May 25, 2016·Antimicrobial Agents and Chemotherapy·Stefano CristalliniFabio Silvio Taccone
Jan 13, 2017·Journal of Clinical Pharmacy and Therapeutics·O FerrándezE Salas
Jan 19, 2017·Revista Brasileira de terapia intensiva·Vitor Yuzo ObaraVinicius Daher Alvares Delfino

❮ Previous
Next ❯

Citations

Apr 30, 2021·International Journal of Clinical Pharmacy·Tatjana Van Der HeggenPieter A J G De Cock
Jun 9, 2021·Cellular and Molecular Gastroenterology and Hepatology·Tânia Martins GarciaIngrid B Renes
Jun 23, 2021·European Journal of Drug Metabolism and Pharmacokinetics·Kannan SridharanMwila Mulubwa

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.