ArticleBritish journal of clinical pharmacology2019
Vancomycin is commonly under-dosed in critically ill children and neonates.
Article in British journal of clinical pharmacology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Vancomycin in neonatal patients: systematic review and call for standardized dosing and monitoring practices.European journal of clinical pharmacology · 2025Pooled it
- Therapeutic drug monitoring of antimicrobials in a paediatric setting: A retrospective single-centre study.British journal of clinical pharmacology · 2026Article
- Impact of eGFR estimation methods on drug dosing in pediatric ICU: a study of serum creatinine vs. cystatin C.European journal of clinical pharmacology · 2026Article
- Machine-learning prediction of pre-dose pharmacokinetics optimizes initial vancomycin dosing in critically ill children.Frontiers in pharmacology · 2026Article
- Revised therapeutic window for vancomycin in pediatric patients: evidence from a retrospective therapeutic drug monitoring study.BMC pharmacology & toxicology · 2025Article
- Pharmacovigilance practice on off-label high-dose of vancomycin in severely ill children.Frontiers in pharmacology · 2025Article
- Successful treatment of Enterococcus gallinarum infection in a neonate with vancomycin: a case report.BMC pediatrics · 2024Article
- Implementing the WHO AWaRe antibiotic book guidance in lower-resource settings: the case of the Lao PDR.JAC-antimicrobial resistance · 2024Review
- Incidence of Antimicrobial-Associated Acute Kidney Injury in Children: A Structured Review.Paediatric drugs · 2024Review
- A real-world cost-effectiveness study of vancomycin versus linezolid for the treatment of late-onset neonatal sepsis in the NICU in China.BMC health services research · 2023Article
- Population pharmacokinetics of vancomycin in very low birth weight neonates.Frontiers in pediatrics · 2023Article
- Vancomycin efficiency and safety of a dosage of 40-60 mg/kg/d and corresponding trough concentrations in children with Gram-positive bacterial sepsis.Frontiers in cellular and infection microbiology · 2023Article
- [Performance evaluation of a precision dosing service for vancomycin in a tertiary level pediatric hospital].Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina) · 2022Article
- Uncovering Discrepancies in IV Vancomycin Infusion Records between Pump Logs and EHR Documentation.Applied clinical informatics · 2022Article
- Implementation of a Vancomycin Dose-Optimization Protocol in Neonates: Impact on Vancomycin Exposure, Biological Parameters, and Clinical Outcomes.Antimicrobial agents and chemotherapy · 2022Article
- Pharmacokinetics and pharmacodynamics of peptide antibiotics.Advanced drug delivery reviews · 2022Review
- Implementation of a Pharmacist-Driven Vancomycin and Aminoglycoside Dosing Service in a Pediatric Hospital.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2022Article
- The relationship between vancomycin AUC/MIC and trough concentration, age, dose, renal function in Chinese critically ill pediatric patients.Pharmacology research & perspectives · 2021Article
- Physical and information workflow mapping of vancomycin therapeutic drug management: A single site case study revealing potential gaps in the process.Journal of medical systems · 2021Article
- Vancomycin dosing and therapeutic drug monitoring practices: guidelines versus real-life.International journal of clinical pharmacy · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsVancomycin is frequently used in critically ill children in whom the drug pharmacokinetics are significantly altered as a result of changes in renal clearance and volume of distribution. Therapeutic drug monitoring (TDM) is recommended to achieve vancomycin trough concentrations between 10 and 20 mg/L. In this study we reviewed vancomycin dosing, TDM and treatment outcomes in paediatric and neonatal intensive care unit patients.
methodsWe reviewed the medical records of all patients receiving intravenous vancomycin in a tertiary paediatric and neonatal intensive care unit over a 10-month period. Demographic, vancomycin dosing, TDM and drug-related adverse effects data were collected.
resultsIn total, 115 children received 126 courses of vancomycin and had at least 1 TDM blood sample taken at steady state. In only 38/126 (30%) courses was the target concentration (10-20 mg/L) achieved at the initial steady state trough sample. Of the 88 courses that had initial trough concentrations outside the target range, the dose was adjusted in only 49 (56%). Overall, minimum doses of 30 mg/kg/day in neonates with a corrected gestational age of <35 weeks, and 50 mg/kg/day in older children, were required to achieve target vancomycin concentrations. Vancomycin-attributable nephrotoxicity occurred in 10/126 (8%) courses and there were no episodes of red man syndrome.
conclusionIn critically ill children, individualised dosing is needed. In the absence of Bayesian model-based dosing, in children with normal renal function, empiric vancomycin doses of at least 30 mg/kg/day in neonates of <35 weeks corrected gestational age, and 50 mg/kg/day in older children, should be considered. Optimisation of TDM practices through the development of protocols, ideally built into electronic medical records, should be considered.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.