Therapeutic monitoring of vancomycin according to initial dosing regimen in pediatric patients / 소아과
Korean Journal of Pediatrics
; : 1000-1005, 2010.
Article
em En
| WPRIM
| ID: wpr-227773
Biblioteca responsável:
WPRO
ABSTRACT
PURPOSE: This study aimed to determine the optimal initial vancomycin dose to achieve appropriate trough levels in pediatric patients. METHODS: We analyzed clinical data for 309 children treated with intravenous vancomycin between 2004 and 2009 at 2 different hospitals in South Korea. The patients were 1-16 years old and exhibited normal renal function. Patient data, including reason for treatment and initial dosing regimen, were reviewed. Two subgroups were identified and compared according to initial vancomycin dose: 40 (35-45) mg/kg/day and 60 (55-65) mg/kg/day. Trough levels were obtained at steady state after at least 4 doses of vancomycin. RESULTS: Patients who received vancomycin had post-operation or wound-related infections (37.2%), localized infection (12.9%), catheter-related infections (9.4%), meningitis (8.7%), or endocarditis (6.8%). Pathogens were confirmed in 79 cases: 28 cases of methicillin-resistant Staphylococcus epidermidis (35.4%) and 25 of methicillin-resistant Staphylococcus aureus (31.6%). Out of the 309 patients, 201 (65%) received vancomycin at 40 mg/kg/day and 108 (35%) at 60 mg/kg/day. Average trough concentrations were significantly different between the groups (P<0.001). Trough levels over 10 mg/L were less likely to be achieved in the 40 mg/kg/day group (14%) than in the 60 mg/kg/day group (49%) (P<0.001). There were no differences in renal function deterioration between the groups. CONCLUSION: A common vancomycin dosing regimen, 40 mg/kg/day, was not high enough to achieve trough levels of over 10 mg/L in pediatric patients. Careful drug monitoring must be performed, and increasing initial dose of vancomycin should be considered in pediatric patients.
Palavras-chave
Texto completo:
1
Base de dados:
WPRIM
Assunto principal:
Staphylococcus epidermidis
/
Vancomicina
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Resistência a Meticilina
/
Monitoramento de Medicamentos
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Endocardite
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Staphylococcus aureus Resistente à Meticilina
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Infecções Relacionadas a Cateter
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República da Coreia
/
Meningite
Limite:
Child
/
Humans
País/Região como assunto:
Asia
Idioma:
En
Revista:
Korean Journal of Pediatrics
Ano de publicação:
2010
Tipo de documento:
Article