A Prospective Pilot Study on the Systemic Absorption of Oral Vancomycin in Children With Colitis
| Autor: | Ravi Jhaveri, Margaret J. Hall, Jacob A. Lohr, Michael J. Steiner, Diana Metropulos, James W. Antoon |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
business.industry Clinical Investigations Systemic absorption Renal function medicine.disease Gastroenterology Surgery 03 medical and health sciences 0302 clinical medicine Refractory Pharmacokinetics 030225 pediatrics Internal medicine Pediatrics Perinatology and Child Health medicine Vancomycin Pharmacology (medical) 030212 general & internal medicine Colitis business Pediatric pharmacology Oral vancomycin medicine.drug |
| Zdroj: | The Journal of Pediatric Pharmacology and Therapeutics. 21:426-431 |
| ISSN: | 1551-6776 |
| Popis: | BACKGROUND: Oral vancomycin is used to treat refractory colitis due to Clostridium dificile infection. Traditionally, oral vancomycin was thought to not be absorbed systemically, but recent adult studies have demonstrated detectable serum levels in over half of patients with severe colitis. This has not been studied in children. OBJECTIVE: To determine the absorption of oral vancomycin and the renal safety profile of oral vancomycin in children hospitalized with colitis. METHODS: We performed a prospective, observational, pilot proof of principle study at the North Carolina Children's Hospital in patients 2 years to 18 years of age receiving oral vancomycin for the treatment of C dificile colitis. Severity of disease was determined using a validated scoring system. Serial serum vancomycin levels and renal function tests were performed during the administration of oral vancomycin. RESULTS: All patients enrolled (n = 8) had mild to moderate C dificile colitis and varying severity of underlying systemic diseases; 7 with inflammatory bowel disease and 1 with acute kidney injury following renal transplantation. No enrolled patients had detectable levels of serum vancomycin. Additionally, no adverse renal outcomes were attributed to oral vancomycin, and no cases of “Red Man” syndrome were observed. CONCLUSIONS: Unlike studies in adult patients, oral vancomycin is likely not absorbed in children with mild to moderate colitis. Further study is needed to determine the pharmacokinetics in severe colitis and those with severe illness in a critical care setting. |
| Databáze: | OpenAIRE |
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