Vancomycin Treatment Failure in Children With Methicillin-Resistant Staphylococcus aureus Bacteremia
| Autor: | Rebecca B. Regen, Rebecca F. Chhim, Sarah S. Schuman, Kelley R. Lee, Sandra R. Arnold |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty business.industry 030106 microbiology Area under the curve Clinical Investigations medicine.disease_cause medicine.disease Methicillin-resistant Staphylococcus aureus Treatment failure 03 medical and health sciences 0302 clinical medicine Treatment success Staphylococcus aureus Internal medicine Bacteremia Pediatrics Perinatology and Child Health Medicine Vancomycin Pharmacology (medical) 030212 general & internal medicine business medicine.drug |
| Popis: | OBJECTIVES Limited data exist regarding clinical outcomes of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections in children treated with vancomycin. Treatment success in adults correlates best with an area under the curve/minimum inhibitory concentration (AUC24/MIC) ratio ≥400. It is unknown if this relationship is useful in children. METHODS Charts of children who received vancomycin ≥5 days for MRSA bacteremia with a steady state trough were reviewed. AUC24/MIC ratios were estimated using 2 different vancomycin clearance equations. Vancomycin treatment failure was defined as persistent bacteremia ≥7 days, recurrent bacteremia within 30 days, or 30-day mortality. RESULTS There were 67 bacteremia episodes in 65 patients. Nine (13.4%) met failure criteria: persistent bacteremia (n = 6), recurrent bacteremia (n = 2), 30-day mortality (n = 1). There were no differences between patients receiving CONCLUSIONS Treatment failure was lower than previously reported in children. AUC24/MIC ratios ≥400 were frequently achieved but were not associated with treatment success, dose, or troughs. Prospective studies using standard definitions of vancomycin treatment failure are needed to understand treatment failure in children with MRSA bacteremia. |
| Databáze: | OpenAIRE |
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