ArticleFrontiers in pediatrics2025
Evaluation of a Bayesian dosing calculator for vancomycin in pediatric patients with augmented renal clearance.
Article in Frontiers in pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Augmented renal clearance (ARC) is increasingly recognized among pediatric oncology and intensive care patients. It can result in subtherapeutic concentrations of renally eliminated drugs like vancomycin. Bayesian dosing tools are recommended to individualize therapy, yet their performance in pediatric ARC remains underexplored. This study evaluated the predictive accuracy of the freely available Bayesian dosing calculator, NextDose, for vancomycin in pediatric patients with and without ARC. NextDose is a web-based application built on a large-population pharmacokinetic model encompassing neonates to adults with varying renal function. Methods: A retrospective observational study included pediatric patients (1-12 years) who received vancomycin and had at least one steady-state serum concentration. ARC was defined as estimated glomerular filtration rate (eGFR) > 130 mL/min/1.73 m Results: A total of 112 pediatric patients were included, of whom 47 (42%) met ARC criteria. The mean age was 5.9 ± 3.4 years; 10.7% were younger than 2 years, 57.2% were aged 2-7 years, and 32.1% were 7-12 years old. Conclusion: NextDose overestimated vancomycin concentrations in
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