Optimization of Vancomycin Dosing in Very Low-Birth-Weight Preterm Neonates
| Autor: | Theresa Madigan, Christine B Teng, Ritu Banerjee, Kevin K. Graner, Jena Koshaish, Kent R. Johnson |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Bacteremia Article Cohort Studies Enterocolitis Necrotizing Vancomycin medicine Retrospective analysis Humans Infant Very Low Birth Weight Dosing Retrospective Studies business.industry Infant Newborn Obstetrics and Gynecology Retrospective cohort study biochemical phenomena metabolism and nutrition medicine.disease Anti-Bacterial Agents Low birth weight Infant Extremely Premature Anesthesia Pediatrics Perinatology and Child Health Necrotizing enterocolitis Female medicine.symptom business Dosing Frequency Infant Premature medicine.drug |
| Zdroj: | American Journal of Perinatology. 32:083-086 |
| ISSN: | 1098-8785 0735-1631 |
| DOI: | 10.1055/s-0034-1376183 |
| Popis: | To compare vancomycin serum trough concentrations and 24-hour area under the serum concentration-versus-time curve (AUC24) among very low-birth-weight (VLBW) premature infants before and after implementation of an institution-wide increase in neonatal vancomycin dosing.We performed a retrospective analysis of vancomycin concentrations among preterm VLBW neonates before (2007-2010) and after (2010-2013) implementation of a new vancomycin dosing protocol consisting of increased vancomycin daily dose and frequency of administration.Neonates weighing 1,500 g and receiving the new vancomycin dosing regimen had lower rates of undetectable trough concentrations (24 vs. 50%, p = 0.04), higher median trough concentrations (10.8 vs. 5.9 µg/mL, p = 0.003), a higher proportion of goal trough concentrations of 10 to 20 µg/mL (35 vs. 4%, p = 0.005), and a significantly higher vancomycin AUC24 (438 vs. 320 mg·h/L, p = 0.004) compared with historical controls.Increasing the vancomycin daily dose and dosing frequency led to an increase in vancomycin trough concentrations and AUC24, and a decrease in the proportion of undetectable (5.0 µg/mL) troughs, without an increase in toxicity among VLBW premature neonates. |
| Databáze: | OpenAIRE |
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