ArticleBritish journal of clinical pharmacology2026
Impact of cumulative glucocorticoid exposure on vancomycin clearance in hospitalized children: A retrospective cohort study.
Article in British journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- Impact of cumulative glucocorticoid exposure on vancomycin clearance in hospitalized children: A retrospective cohort study.British journal of clinical pharmacology · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAugmented renal clearance (ARC) can lead to subtherapeutic vancomycin exposure in children. The impact of prior glucocorticoid (GC) exposure on vancomycin pharmacokinetics remains poorly understood. We evaluated the association between GC exposure and vancomycin clearance in paediatric patients.
methodsWe conducted a retrospective cohort study of paediatric patients undergoing vancomycin therapeutic drug monitoring. GC exposure within 2 years was quantified as prednisolone-equivalent dose. Vancomycin clearance was estimated using the allometrically normalized dose-to-level (D/L) ratio. Associations were assessed using correlation and multivariable regression adjusted for age, sex, eGFR and inflammatory markers.
resultsAmong 245 hospitalized children receiving vancomycin, 157 (64.1%) had prior GC exposure. GC-exposed children had higher vancomycin D/L ratios (p = .018). Cumulative GC exposure showed weak positive associations with higher vancomycin clearance (2-year window: Spearman ρ = .16, p = .013). However, in the fully adjusted model, the association between cumulative GC exposure and D/L ratio was not significant (β = -.0077 per 10 mg kg
conclusionsChildren with prior GC exposure had lower early vancomycin trough concentrations and higher unadjusted D/L ratios. However, the association between GC exposure and vancomycin clearance was attenuated after adjustment, suggesting that GC exposure may reflect underlying physiologic or disease-related factors rather than an independent determinant of clearance. Closer therapeutic drug monitoring may be warranted at treatment initiation.
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