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J Pediatr Pharmacol Ther. 2009 Apr;14(2):86-93. doi: 10.5863/1551-6776-14.2.86.

Correlation of vancomycin dosing to serum concentrations in pediatric patients: a retrospective database review.

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1
Samford University McWhorter School of Pharmacy, Birmingham, Alabama.

Abstract

OBJECTIVES:

Appropriate antimicrobial dosing maximizes therapeutic benefit while minimizing development of antimicrobial resistance. Common pediatric references recommend vancomycin dosing of 40 mg/kg/day divided every 6 to 8 hours for non-central nervous system infections, while some clinicians report utilizing higher initial doses to optimize efficacy. This study compares vancomycin serum concentrations following traditional dosing of 10 mg/kg/dose every 6 to 8 hours versus 15 to 20 mg/kg/dose every 6 to 8 hours.

STUDY DESIGN:

Retrospective database review of vancomycin serum concentrations in pediatric patients.

RESULTS:

Three hundred fifty-seven patients were analyzed. The mean peak concentration of the 10 mg/kg groups every 6 and every 8 hours were below 25 mg/L, whereas the mean peak concentrations of the 15 mg/ kg groups every 6 and 8 hours were within the 25-40 mg/L range (p < 0.001). The mean trough concentration of the 10 mg/kg group every 6 hours was within the 5-15 mg/L range while the 10 mg/kg group dosed every 8 hours was below target. However, the mean trough concentrations of the 15 mg/kg group dosed every 6 and 8 hours were both within the 5-15 mg/L range (p < 0.001).

CONCLUSIONS:

Vancomycin doses of 15 mg/kg every 6 to 8 hours produce peak and trough serum concentrations within target range more often than 10 mg/kg every 6 to 8 hours.

KEYWORDS:

pediatrics; pharmacokinetics; vancomycin dosing; vancomycin serum concentrations

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