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Curr Drug Saf. 2012 Nov 1;7(5):375-81.

Prospective evaluation of the dosing regimen of vancomycin in children of different weight categories.

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Department of Pediatric Hematology Oncology, Meyer Children’s Hospital, Haifa, Israel.



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.


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.


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.


PK properties of all weight groups were similar. More frequent and higher doses are needed to achieve the goals of current guidelines.

[Indexed for MEDLINE]

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