Vancomycin use, dosing and serum trough concentrations in the pediatric population: a retrospective institutional review

Autor: Gilda Villarreal, Kevin Rajon, Régis Vaillancourt, Nisha Varughese
Rok vydání: 2017
Předmět:
Canada
Pediatrics
medicine.medical_specialty
Adolescent
lcsh:RS1-441
Pharmaceutical Science
Pharmacy
mesh:Infant
mesh:Drug Monitoring
Pharmacy Service
medicine.disease_cause
Trough (economics)
030226 pharmacology & pharmacy
mesh:Adolescent
lcsh:Pharmacy and materia medica
Hospital
03 medical and health sciences
Minimum inhibitory concentration
0302 clinical medicine
Pharmacokinetics
Vancomycin
Chart review
Medicine
030212 general & internal medicine
Dosing
Original Research
mesh:Inpatients
Inpatients
mesh:Canada
Clinical Audit
business.industry
lcsh:RM1-950
Infant
mesh:Vancomycin
mesh:Hospital
mesh:Pharmacokinetics
mesh:Clinical Audit
lcsh:Therapeutics. Pharmacology
Staphylococcus aureus
Drug Monitoring
business
mesh:Pharmacy Service
Pharmacy Service Hospital
Pediatric population
medicine.drug
Zdroj: Pharmacy Practice (Granada), Volume: 15, Issue: 2, Article number: 887, Published: JUN 2017
Pharmacy Practice
Pharmacy Practice (Granada) v.15 n.2 2017
SciELO España. Revistas Científicas Españolas de Ciencias de la Salud
instname
Pharmacy Practice, Vol 15, Iss 2, Pp 887-887 (2017)
ISSN: 1886-3655
1885-642X
DOI: 10.18549/pharmpract.2017.02.887
Popis: Background: Vancomycin is used primarily for Gram-positive infections. Recommended dosage regimens and targeted therapeutic levels vary between institutions. Objectives: This study aims to describe therapeutic levels according to initial vancomycin doses and patient’s age. A secondary objective was to evaluate appropriateness of vancomycin use in our hospital. Methods: A retrospective chart review was conducted at the Children’s Hospital of Eastern Ontario. Patients included in this study were classified by age (neonates, infants, children and adolescents) and categorized into those who received vancomycin ≤5 and >5 days. Initial vancomycin dosing regimens and corresponding initial trough levels obtained were evaluated. Initial trough levels drawn in relation to the third, fourth, or fifth doses corresponding to the first course of therapy were analyzed. Acceptable trough levels ranged from 5-20 mg/L. Results: One-hundred-and-sixty-four patients who received intravenous vancomycin in 2013 were included. Of the 229 courses of vancomycin, 190 (83%) were used 5 days or less (mean 4.9 days). Sixteen infants (88.9%) and 21 adolescents (100%), who received vancomycin empiric dosing of 60 mg/kg/day, had initial trough levels >5mg/L. However, in the children’s group 20 (37.7%) did not reach levels >5 mg/L. None of vancomycin minimum inhibitory concentration (MIC) values were >1mg/L for the four patients who had infections due to methicillin-resistant Staphylococcus aureus strains. Conclusions: In our institution, initial empiric vancomycin dosing of 60 mg/kg/day resulted in levels ≥5mg/L in most infants and adolescents. It remains unclear why some children aged 1-12 years did not achieve these levels.
Databáze: OpenAIRE
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