ArticlePharmacy practice
Vancomycin use, dosing and serum trough concentrations in the pediatric population: a retrospective institutional review.
Article in Pharmacy practice. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 15 citations in OpenAlex.
- Practical approaches to improve vancomycin-related patient outcomes in pediatrics- an alternative strategy when AUC/MIC is not feasible.BMC pharmacology & toxicology · 2022Article
- Vancomycin dosing and therapeutic drug monitoring practices: guidelines versus real-life.International journal of clinical pharmacy · 2021Article
- Evaluation of vancomycin initial trough levels in children: A 1-year retrospective study.SAGE open medicine · 2020Article
- Vancomycin is commonly under-dosed in critically ill children and neonates.British journal of clinical pharmacology · 2019Article
- Does vancomycin administered at an empirical dose ensure coverage of pediatric patients against gram-positive pathogens?Revista Brasileira de terapia intensivaObservational
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVancomycin is used primarily for Gram-positive infections. Recommended dosage regimens and targeted therapeutic levels vary between institutions.
objectivesThis study aims to describe therapeutic levels according to initial vancomycin doses and patient's age. A secondary objective was to evaluate appropriateness of vancomycin use in our hospital.
methodsA retrospective chart review was conducted at the Children's Hospital of Eastern Ontario. Patients included in this study were classified by age (neonates, infants, children and adolescents) and categorized into those who received vancomycin ≤5 and >5 days. Initial vancomycin dosing regimens and corresponding initial trough levels obtained were evaluated. Initial trough levels drawn in relation to the third, fourth, or fifth doses corresponding to the first course of therapy were analyzed. Acceptable trough levels ranged from 5-20 mg/L.
resultsOne-hundred-and-sixty-four patients who received intravenous vancomycin in 2013 were included. Of the 229 courses of vancomycin, 190 (83%) were used 5 days or less (mean 4.9 days). Sixteen infants (88.9%) and 21 adolescents (100%), who received vancomycin empiric dosing of 60 mg/kg/day, had initial trough levels >5mg/L. However, in the children's group 20 (37.7%) did not reach levels >5 mg/L. None of vancomycin minimum inhibitory concentration (MIC) values were >1mg/L for the four patients who had infections due to methicillin-resistant Staphylococcus aureus strains.
conclusionsIn our institution, initial empiric vancomycin dosing of 60 mg/kg/day resulted in levels ≥5mg/L in most infants and adolescents. It remains unclear why some children aged 1-12 years did not achieve these levels.
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