Evidence map›Paper›PMID 41428193›Full record

SynthesisEuropean journal of clinical pharmacology2025

Vancomycin in neonatal patients: systematic review and call for standardized dosing and monitoring practices.

Cesar Helbel, Camila Brusarosco Ferreira, Camila Ferreira Amaral Previato, Edvalkia Magna Teobaldo da Rocha, Guilherme Henrique Oliveira Silva, Diego Cardozo Mascarenhas, Gessilda de Alcântra Nogueira de Melo, Vagner Roberto Batistela, Estela Louro, Simone Tomás Gonçalves and 2 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of clinical pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Cesar HelbelGraduate Program in Health Sciences, State University of Maringá , City: Maringá, 87020-900, PR, Brazil.
Camila Brusarosco FerreiraDepartment of Pharmacology and Therapeutics, State University of Maringá, City: Maringá, 87020-900, PR, Brazil.
Camila Ferreira Amaral PreviatoGraduate Program in Health Sciences, State University of Maringá , City: Maringá, 87020-900, PR, Brazil.
Edvalkia Magna Teobaldo da RochaGraduate Program in Pharmaceutical Sciences, State University of Maringá , City: Maringá, 87020-900, PR, Brazil.
Guilherme Henrique Oliveira SilvaGraduate Program in Health Sciences, State University of Maringá , City: Maringá, 87020-900, PR, Brazil.
Diego Cardozo MascarenhasDepartment of Pharmacology and Therapeutics, State University of Maringá, City: Maringá, 87020-900, PR, Brazil.
Gessilda de Alcântra Nogueira de MeloDepartment of Pharmacology and Therapeutics, State University of Maringá, City: Maringá, 87020-900, PR, Brazil.
Vagner Roberto BatistelaGraduate Program in Pharmaceutical Sciences, State University of Maringá , City: Maringá, 87020-900, PR, Brazil.
Estela LouroDepartment of Pharmacy, State University of Maringá, City: Maringá, 87020-900, PR, Brazil.
Simone Tomás GonçalvesDepartment of Pharmacy, State University of Maringá, City: Maringá, 87020-900, PR, Brazil.
Vanderly JaneiroDepartment of Statistics, State University of Maringá, City: Maringá, 87020-900, PR, Brazil.
Roberto Kenji Nakamura CumanGraduate Program in Health Sciences, State University of Maringá , City: Maringá, 87020-900, PR, Brazil. rkncuman@uem.br.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis systematic review aimed at consolidating evidence regarding vancomycin dosing regimens, therapeutic drug monitoring (TDM) practices, clinical efficacy, and toxicity profiles in neonates admitted to neonatal intensive care units (NICUs). The primary research question focused on identifying the most effective and safe vancomycin protocols for this vulnerable population.

methodsFollowing PRISMA guidelines, a comprehensive search was conducted in six databases: PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Lilacs. Eligible studies included observational cohorts and randomized clinical trials involving neonates receiving intravenous vancomycin with reported dosing and TDM data. Data extraction encompassed study design, dosing regimens, serum concentration targets, efficacy outcomes, and toxicity reports.

resultsThirty-two studies met inclusion criteria, revealing substantial heterogeneity in vancomycin dosing strategies, target trough concentrations, and evaluation methods for efficacy and toxicity. Target serum concentrations varied widely (5-30 mg/L), and dosing regimens ranged from 10 to 61 mg/kg/day. Only three studies assessed clinical efficacy, and eleven evaluated nephrotoxicity risk, with reported nephrotoxicity rates between 1.1% and 14%. Variability in methods limited the comparability across studies.

conclusionsVancomycin use in neonates lacks standardized dosing and monitoring practices, making it challenging to define an optimal therapeutic protocol. Greater consistency in clinical approaches and further high-quality studies are urgently needed to establish safe and effective vancomycin management strategies for neonatal patients.

Indexed as

Anti-Bacterial AgentsDrug MonitoringVancomycinHumansInfant, NewbornIntensive Care Units, NeonatalAnti-Bacterial AgentsVancomycinDosing regimensNeonatesNephrotoxicityTherapeutic drug monitoringVancomycin

Identifiers

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Registered trials

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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.