ArticleAntimicrobial agents and chemotherapy2019
Revising Pediatric Vancomycin Dosing Accounting for Nephrotoxicity in a Pharmacokinetic-Pharmacodynamic Model.
Article in Antimicrobial agents and chemotherapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 4 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
23 citing papers in PubMed, 4 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
- Precision Dosing of Vancomycin: A Systematic Review of Population Pharmacokinetics Models and Comparative Evaluation of Software Tools.Clinical pharmacokinetics · 2026Pooled it
- Pharmacokinetics of Vancomycin in Critically Ill Children: A Systematic Review.European journal of drug metabolism and pharmacokinetics · 2022Pooled it
- Population Pharmacokinetic Models of Vancomycin in Paediatric Patients: A Systematic Review.Clinical pharmacokinetics · 2021Pooled it
- Multisite Analysis of Vancomycin Concentration Predictions in a Bayesian Software in Adult and Pediatric Patients With and Without Acute Kidney Injury.Pharmacotherapy · 2026Article
- Vancomycin AUCAntibiotics (Basel, Switzerland) · 2026Article
- Case report: Delayed onset rash, delirium, and cross allergic reactions caused by sequential administration of cefoperazone sulbactam, meropenem, and piperacillin tazobactam.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Impact of Febrile State on Vancomycin Clearance in Pediatric Patients: Insights From Population Pharmacokinetic Modeling.Pharmaceutical research · 2026Article
- Population Pharmacokinetic and Exposure-Response Analysis of Vancomycin Nephrotoxicity in Cystic Fibrosis Patients.Pediatric pulmonology · 2026Article
- Model-informed precision dosing of vancomycin in children 3 months to 18 years of age using Australia-wide data.Antimicrobial agents and chemotherapy · 2026Article
- Pharmacodynamics of Vancomycin Against Coagulase-Negative Staphylococci Bloodstream Infections.Pharmacology research & perspectives · 2025Review
- Prediction of Vancomycin Area Under the Curve With Trough Concentrations Only: Performance Evaluation of Pediatric Population Pharmacokinetic Models.The Journal of infectious diseases · 2025Article
- Pharmacovigilance practice on off-label high-dose of vancomycin in severely ill children.Frontiers in pharmacology · 2025Article
- Pilot Pharmacokinetic Study in Healthy Adults Using Intravascular Microdialysis Catheters Modified for Use in Paediatric Patients to Assess Vancomycin Blood Levels.Clinical pharmacokinetics · 2023Article
- Evaluation of Neonatal and Paediatric Vancomycin Pharmacokinetic Models and the Impact of Maturation and Serum Creatinine Covariates in a Large Multicentre Data Set.Clinical pharmacokinetics · 2023Article
- Population Pharmacokinetics and Pharmacodynamics of Vancomycin in Pediatric Patients With Various Degrees of Renal Function.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2022Article
- Pharmacokinetic assessment of vancomycin in critically ill patients and nephrotoxicity prediction using individualized pharmacokinetic parameters.Frontiers in pharmacology · 2022Article
- An Update on Population Pharmacokinetic Analyses of Vancomycin, Part II: In Pediatric Patients.Clinical pharmacokinetics · 2022Review
- Changes of renal transporters in the kinetic process of VCM-induced nephrotoxicity in mice.Toxicology research · 2021Article
- Amikacin or Vancomycin Exposure Alters the Postnatal Serum Creatinine Dynamics in Extreme Low Birth Weight Neonates.International journal of environmental research and public health · 2021Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
Abstract
This study aimed to suggest an initial pediatric vancomycin dose regimen through population pharmacokinetic-pharmacodynamic modeling. A population pharmacokinetic approach was used to analyze vancomycin concentration-time data from a large pediatric cohort. Pharmacokinetic target attainment for patients with bloodstream isolates was compared with clinical outcome using logistic regression and classification and regression trees. Change in serum creatinine during treatment was used as an indicator of acute nephrotoxicity. Probability of acute kidney injury (50% increase from baseline) or kidney failure (75% increase from baseline) was evaluated using logistic regression. An initial dosing regimen was derived, personalized by age, weight, and serum creatinine, using stochastic simulations. Data from 785 hospitalized pediatric patients (1 day to 21 years of age) with suspected Gram-positive infections were collected. Estimated (relative standard error) typical clearance, volume of distribution 1, intercompartmental clearance, and volume of distribution 2 were (standardized to 70 kg) 4.84 (2.38) liters/h, 39.9 (8.15) liters, 3.85 (17.3) liters/h, and 37.8 (10.2) liters, respectively. While cumulative vancomycin exposure correlated positively with the development of nephrotoxicity (713 patients), no clear relationship between vancomycin area under the plasma concentration-time curve and efficacy was found (102 patients). Predicted probability of acute kidney injury and kidney failure with the optimized dosing regimen at day 5 was 10 to 15% and 5 to 10%, increasing by approximately 50% on day 7 and roughly 100% on day 10 across all age groups. This study presents the first data-driven pediatric dose selection to date accounting for nephrotoxicity, and it indicates that cumulative vancomycin exposure best describes risk of acute kidney injury and acute kidney failure.
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Registered trials
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