Prospective Evaluation of the Dosing Regimen of Vancomycin in Children of Different Weight Categories

Author(s): Laila Nassar, Salim Hadad, Aharon Gefen, Yael Shachor-Meyouhas, Tatiana Mashiach, Norberto Krivoy, Imad Kassis

Journal Name: Current Drug Safety

Volume 7 , Issue 5 , 2012

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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

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Article Details

Year: 2012
Published on: 06 February, 2013
Page: [375 - 381]
Pages: 7
DOI: 10.2174/1574886311207050009
Price: $65

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