ArticleTherapeutic drug monitoring2015
Evaluation of Vancomycin Use in Late-Onset Neonatal Sepsis Using the Area Under the Concentration-Time Curve to the Minimum Inhibitory Concentration ≥400 Target.
Article in Therapeutic drug monitoring, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 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
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Systematic review and scoring-based selection of pharmacokinetic models for precision dosing of vancomycin in neonates and children.British journal of clinical pharmacology · 2026Pooled it
- Population Pharmacokinetic Models of Vancomycin in Paediatric Patients: A Systematic Review.Clinical pharmacokinetics · 2021Pooled it
- Clinical Model-Informed Precision Dosing Consult Service for Accelerating Personalized Medication in Pediatric Patients.Clinical pharmacology and therapeutics · 2026Review
- Vancomycin Therapeutic Drug Monitoring, Clinical Outcomes and Population Pharmacokinetic Model Evaluation in Neonates.Children (Basel, Switzerland) · 2026Article
- Vancomycin dosing in neonates: enhancing outcomes using population pharmacokinetics and simulation.Frontiers in antibiotics · 2025Article
- A Review of Vancomycin, Gentamicin, and Amikacin Population Pharmacokinetic Models in Neonates and Infants.Clinical pharmacokinetics · 2025Review
- Variation in vancomycin dosing and therapeutic drug monitoring practices in neonatal intensive care units.International journal of clinical pharmacy · 2022Article
- An Update on Population Pharmacokinetic Analyses of Vancomycin, Part II: In Pediatric Patients.Clinical pharmacokinetics · 2022Review
- Reduced Vancomycin Susceptibility, MRSA and Treatment Failure in Pediatric Staphylococcus aureus Bloodstream Infections.The Pediatric infectious disease journal · 2021Article
- Target Attainment and Clinical Efficacy for Vancomycin in Neonates: Systematic Review.Antibiotics (Basel, Switzerland) · 2021Review
- Therapeutic Drug Monitoring Is a Feasible Tool to Personalize Drug Administration in Neonates Using New Techniques: An Overview on the Pharmacokinetics and Pharmacodynamics in Neonatal Age.International journal of molecular sciences · 2020Review
- Population Pharmacokinetics of Vancomycin in Kidney Transplant Recipients: Model Building and Parameter Optimization.Frontiers in pharmacology · 2020Article
- Challenges of Vancomycin Dosing and Therapeutic Monitoring in Neonates.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2020Review
- Vancomycin drug monitoring in infants with CoNS sepsis-target attainment, microbiological response and nephrotoxicity.Journal of perinatology : official journal of the California Perinatal Association · 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
- Vancomycin therapeutic drug monitoring and population pharmacokinetic models in special patient subpopulations.Pharmacology research & perspectives · 2018Article
- Evaluating the Relationship between Vancomycin Trough Concentration and 24-Hour Area under the Concentration-Time Curve in Neonates.Antimicrobial agents and chemotherapy · 2018Article
- Optimizing the Use of Antibacterial Agents in the Neonatal Period.Paediatric drugs · 2016Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
aimTo develop a vancomycin population pharmacokinetic model and assess the probability of attaining a pharmacodynamic target associated with clinical and microbiological success, a ratio of the 24-hour area under the concentration-time curve to the minimum inhibitory concentration (MIC) ≥ 400, in a 5-year clinical cohort of preterm and term neonatal patients with late-onset staphylococcal sepsis.
methodsTherapeutic drug monitoring data were obtained from septic neonates with ≥1 vancomycin concentration(s) from January 2006 to September 2011. Only neonates with a postnatal age of >72 hours and a positive microbiological culture were included. Population pharmacokinetic model was developed using nonlinear mixed effects modeling (NONMEM 7.2). Eleven demographic characteristics were evaluated as covariates. Probabilities of achieving the pharmacodynamic target were evaluated.
resultsA 1-compartment model with first-order elimination was constructed from 528 vancomycin concentrations collected from 152 preterm and term neonates. Body weight, creatinine clearance (CL), and postmenstrual age were identified as significant covariates. Estimated vancomycin CL and volume of distribution for typical neonates were 0.068 ± 0.03 L·h·kg and 0.62 ± 0.13 L/kg, respectively. Coagulase-negative staphylococci (85.5%) and Staphylococcus aureus (14.5%) were the common pathogenic organisms. The distribution of vancomycin MIC breakpoints was composed of approximately 70% MIC breakpoint of ≤2 mcg/mL. Approximately 54% of neonates, with a median serum creatinine concentration of 0.44 mg/dL, achieved the target ratio of 24-hour area under the concentration-time curve to the MIC ≥ 400 with a median daily dose of 30 (interquartile range, 21-42) mg/kg.
conclusionsBody weight, creatinine CL, and postmenstrual age significantly influenced vancomycin CL. The current vancomycin doses are acceptable at MICs ≤1 mcg/mL because they are likely to achieve the pharmacodynamic target in the majority of neonatal patients, although higher doses may be considered for more resistant staphylococcal infections.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.