Abstract
Background: Pharmacokinetics (PK), pharmacodynamics and optimal dosing of vancomycin in obese children is not known. Higher trough levels of vancomycin may improve outcomes. This prospective study evaluated the appropriateness of twice-daily regimen for the adherence to guidelines, among obese and non obese children.
Methods: Children receiving vancomycin, (20 mg/kg BID) were included. Patients were divided into 3 groups. Adequacy was defined as trough level ≥ 10mg/L and AUC/MIC > 400. An alternative-dosing regimen was calculated based on individual PK parameters.
Results: Seventy-seven pairs (trough, peak) were taken from 51 children. Mean trough level was 3.36±2.58, only 3% fell in therapeutic range, no statistical difference was observed between obese, normal weight or underweight groups. One child had an AUC/MIC > 400. All children recovered.
Conclusion: PK properties of all weight groups were similar. More frequent and higher doses are needed to achieve the goals of current guidelines.
Keywords: Guidelines, obesity, pediatric dosing, pharmacokinetics, trough levels, vancomycin, antimicrobials, antifungals, invasive, bacterial meningitis
Current Drug Safety
Title:Prospective Evaluation of the Dosing Regimen of Vancomycin in Children of Different Weight Categories
Volume: 7 Issue: 5
Author(s): Laila Nassar, Salim Hadad, Aharon Gefen, Yael Shachor-Meyouhas, Tatiana Mashiach, Norberto Krivoy and Imad Kassis
Affiliation:
Keywords: Guidelines, obesity, pediatric dosing, pharmacokinetics, trough levels, vancomycin, antimicrobials, antifungals, invasive, bacterial meningitis
Abstract: Background: Pharmacokinetics (PK), pharmacodynamics and optimal dosing of vancomycin in obese children is not known. Higher trough levels of vancomycin may improve outcomes. This prospective study evaluated the appropriateness of twice-daily regimen for the adherence to guidelines, among obese and non obese children.
Methods: Children receiving vancomycin, (20 mg/kg BID) were included. Patients were divided into 3 groups. Adequacy was defined as trough level ≥ 10mg/L and AUC/MIC > 400. An alternative-dosing regimen was calculated based on individual PK parameters.
Results: Seventy-seven pairs (trough, peak) were taken from 51 children. Mean trough level was 3.36±2.58, only 3% fell in therapeutic range, no statistical difference was observed between obese, normal weight or underweight groups. One child had an AUC/MIC > 400. All children recovered.
Conclusion: PK properties of all weight groups were similar. More frequent and higher doses are needed to achieve the goals of current guidelines.
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Nassar Laila, Hadad Salim, Gefen Aharon, Shachor-Meyouhas Yael, Mashiach Tatiana, Krivoy Norberto and Kassis Imad, Prospective Evaluation of the Dosing Regimen of Vancomycin in Children of Different Weight Categories, Current Drug Safety 2012; 7 (5) . https://dx.doi.org/10.2174/1574886311207050009
DOI https://dx.doi.org/10.2174/1574886311207050009 |
Print ISSN 1574-8863 |
Publisher Name Bentham Science Publisher |
Online ISSN 2212-3911 |
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