ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2018
Factors impacting unbound vancomycin concentrations in neonates and young infants.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Risk Factors for Nephrotoxicity Among Neonates Receiving Vancomycin: A Systematic Review and Meta-analysis.Paediatric drugs · 2025Pooled it
- Pharmacokinetics of Vancomycin in Critically Ill Children: A Systematic Review.European journal of drug metabolism and pharmacokinetics · 2022Pooled it
- Evaluating Bayesian Vancomycin Dosage Adjustment in Neonates: A Simulation-Based Virtual TDM Study.Clinical pharmacokinetics · 2026Article
- Human serum albumin: prediction model and reference values for preterm and term neonates.Pediatric research · 2026Article
- Advances in Pediatric Therapeutic Drug Monitoring.Pediatrics · 2026Review
- Mathematical Albumin Function for Neonates Undergoing Therapeutic Hypothermia in Comparison with Control Neonates.Journal of clinical pharmacology · 2025Article
- Population pharmacokinetics of vancomycin in non-extremely preterm neonates based on real-world studies: influence of daily fluid input and diuretics.Microbiology spectrum · 2025Article
- Vancomycin Area Under the Curve to Minimum Inhibitory Concentration Ratio for Treatment Effectiveness in Pediatric and Neonatal Staphylococcal Infections: A Systematic Review.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2025Article
- Correlation Between Vancomycin Trough Concentrations and C-Reactive Protein in Neonates: A Retrospective Observational Study from a Tertiary Hospital in China.Infection and drug resistance · 2025Article
- Population pharmacokinetic analysis for dose regimen optimization of vancomycin in Southern Chinese children.CPT: pharmacometrics & systems pharmacology · 2024Article
- Real-Life Vancomycin Therapeutic Drug Monitoring in Coagulase-Negative Staphylococcal Bacteremia in Neonatal and Pediatric Intensive Care Unit: Are We Underestimating Augmented Renal Clearance?Antibiotics (Basel, Switzerland) · 2023Article
- Developmental Pharmacokinetics of Antibiotics Used in Neonatal ICU: Focus on Preterm Infants.Biomedicines · 2023Review
- Use of Antibiotics in Preterm Newborns.Antibiotics (Basel, Switzerland) · 2022Review
- Implementation of a Vancomycin Dose-Optimization Protocol in Neonates: Impact on Vancomycin Exposure, Biological Parameters, and Clinical Outcomes.Antimicrobial agents and chemotherapy · 2022Article
- Model-Based Approach for Optimizing Ceftobiprole Dosage in Pediatric Patients.Antimicrobial agents and chemotherapy · 2021Article
- Impact of Changes in Free Concentrations and Drug-Protein Binding on Drug Dosing Regimens in Special Populations and Disease States.Journal of pharmaceutical sciences · 2021Review
- Pharmacokinetics of Antibiotics in Pediatric Intensive Care: Fostering Variability to Attain Precision Medicine.Antibiotics (Basel, Switzerland) · 2021Review
- Population Pharmacokinetic Analysis and Dose Regimen Optimization in Japanese Infants with an Extremely Low Birth Weight.Antimicrobial agents and chemotherapy · 2021Article
- Prediction of Unbound Vancomycin Levels in Intensive Care Unit and Nonintensive Care Unit Patients: Total Bilirubin May Play an Important Role.Infection and drug resistance · 2021Article
- Prediction of Unbound Ceftriaxone Concentration in Children: Simple Bioanalysis Method and Basic Mathematical Equation.Antimicrobial agents and chemotherapy · 2020Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Vancomycin pharmacokinetic (PK) and pharmacodynamic (PD) data in neonates are based on total concentrations. However, only unbound vancomycin is pharmacologically active. The objective was to determine vancomycin protein binding and the covariates impacting unbound vancomycin concentration in neonates and young infants. In neonates and young infants to whom vancomycin was administered intermittently for medical indications, total and unbound vancomycin plasma concentrations were determined using LC-MS/MS. Sampling occurred randomly during vancomycin exposure, covering a broad range of concentrations. Impact of covariates on unbound vancomycin concentration was determined using linear regression. Significant results of the univariate regressions were entered in a stepwise multiple regression. Passing-Bablok regression and Bland-Altman were used to assess the difference between measured and calculated unbound vancomycin concentration. Thirty-seven samples in 33 patients (median (interquartile range) gestational age 35 (29-39) weeks) were collected. Median total and unbound vancomycin concentrations were 14.2 (7.4-20.6) and 13.6 (7.2-22.5) mg/L, respectively. Median unbound fraction was 0.90 (0.77-0.98). Multiple regression revealed total vancomycin concentration (β = 0.884, p < 0.001) and albumin (β = - 0.323, p = 0.007) as most important covariates of unbound vancomycin concentrations, with an R
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