ArticleBMC pediatrics2014
Inadequate vancomycin therapy in term and preterm neonates: a retrospective analysis of trough serum concentrations in relation to minimal inhibitory concentrations.
Article in BMC pediatrics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Vancomycin in neonatal patients: systematic review and call for standardized dosing and monitoring practices.European journal of clinical pharmacology · 2025Pooled it
- Relationship between Vancomycin Trough Serum Concentrations and Clinical Outcomes in Children: a Systematic Review and Meta-Analysis.Antimicrobial agents and chemotherapy · 2022Pooled it
- Pharmacokinetic model-guided enoxaparin dosing in the Neonatal ICU: Retrospective cohort study to plan for prospective feasibility trial.Clinical and translational science · 2024Article
- Pharmacokinetic and Pharmacodynamic Considerations of Antibiotic Use in Neonates.Antibiotics (Basel, Switzerland) · 2023Review
- Predictive Performance of Pharmacokinetic Model-Based Virtual Trials of Vancomycin in Neonates: Mathematics Matches Clinical Observation.Clinical pharmacokinetics · 2022Article
- Implementation of a Vancomycin Dose-Optimization Protocol in Neonates: Impact on Vancomycin Exposure, Biological Parameters, and Clinical Outcomes.Antimicrobial agents and chemotherapy · 2022Article
- Target Attainment and Clinical Efficacy for Vancomycin in Neonates: Systematic Review.Antibiotics (Basel, Switzerland) · 2021Review
- Achieving Vancomycin Troughs Within Goal Range in Low Birth Weight Neonates.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2021Article
- How to Treat Sepsis in the Background of Resistance?: Role of Pharmacodynamics / Pharmacokinetics in Treating Sepsis.Indian journal of pediatrics · 2020Review
- Vancomycin Prescribing Practices and Therapeutic Drug Monitoring for Critically Ill Neonatal and Pediatric Patients: A Survey of Physicians and Pharmacists in Hong Kong.Frontiers in pediatrics · 2020Article
- Factors impacting unbound vancomycin concentrations in neonates and young infants.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2018Article
- Key Components for Antibiotic Dose Optimization of Sepsis in Neonates and Infants.Frontiers in pediatrics · 2018Review
- Coagulase negative staphylococcal sepsis in neonates: do we need to adapt vancomycin dose or target?BMC pediatrics · 2016Article
- Optimizing the Use of Antibacterial Agents in the Neonatal Period.Paediatric drugs · 2016Article
- Vancomycin use, dosing and serum trough concentrations in the pediatric population: a retrospective institutional review.Pharmacy practiceArticle
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVancomycin is effective against gram-positive bacteria and the first-line antibiotic for treatment of proven coagulase-negative staphylococcal infections. The aim of this study is bipartite: first, to assess the percentage of therapeutic initial trough serum concentrations and second, to evaluate the adequacy of the therapeutic range in interrelationship with the observed MIC-values in neonates.
methodsIn this study, preterm and term neonates admitted at a tertiary NICU in the Netherlands from January 2009 to December 2012 and treated with vancomycin for a proven gram-positive infection were included. Trough serum concentrations were measured prior to administration of the 5th dose. Trough concentrations in the range of 10 to 15 mg/L were considered therapeutic. Staphylococcal species minimal inhibitory concentrations (MIC's) were determined using the E-test method. Species identification was performed by matrix-assisted laser desorption/ionisation mass spectrometry.
resultsOf the 112 neonates, 53 neonates (47%) had sub-therapeutic initial trough serum concentrations of vancomycin, whereas 22% had supra-therapeutic initial trough serum concentrations. In all patients doses were adjusted on basis of the initial trough concentration. In 40% (23/57) of the neonates the second trough concentration remained sub-therapeutic. MIC's were determined for 30 coagulase-negative Staphylococcus isolates obtained from 19 patients. Only 4 out of 19 subjects had a trough concentration greater than tenfold the MIC.
conclusionsForty-seven percent of the neonates had sub-therapeutic initial trough serum concentrations of vancomycin. The MIC-data indicate that the percentages of underdosed patients may be greater. It may be advisable to increase the lower limit of the therapeutic range for European neonates.
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