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Does vancomycin administered at an empirical dose ensure coverage of pediatric patients against gram-positive pathogens?

ABSTRACT: OBJECTIVE:To investigate the vancomycin effectiveness against gram-positive pathogens with the minimum inhibitory concentration of 1mg/L in pediatric patients based on the area under the curve and the minimum inhibitory concentration ratio > 400. METHODS:A population of 22 pediatric patients (13 boys) admitted to the pediatric intensive care unit with preserved renal function was stratified in two groups (G1 < 7 years and G2 ? 7 years). After the fourth dose administered of vancomycin (10 - 15mg/kg every 6 hours) was administered, two blood samples were collected (third and fifth hours), followed by serum measurement by immunoassays to investigate the pharmacokinetics and antimicrobial coverage. RESULTS:There was no difference between the groups regarding dose, trough level or area under the curve. Coverage against gram-positive pathogens with a minimum inhibitory concentration of 1mg/L occurred in only 46% of patients in both groups. The pharmacokinetics in both groups were altered relative to the reference values, and the groups differed in regard to increased total body clearance and shortening of the biological half-life, which were more pronounced in younger patients. CONCLUSION:A minimum empirical dose of 60mg/kg per day should be prescribed for pediatric patients in intensive care units with preserved renal function. The use of the ratio between the area under the curve and minimum inhibitory concentration in the evaluation of vancomycin coverage is recommended to achieve the desired outcome, since the pharmacokinetics are altered in these patients, which may impact the effectiveness of the antimicrobial.

SUBMITTER: Pires FR

PROVIDER: S-EPMC7595722 | biostudies-literature | 2020 Jul-Sep

REPOSITORIES: biostudies-literature

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Does vancomycin administered at an empirical dose ensure coverage of pediatric patients against gram-positive pathogens?

Pires Frederico Ribeiro FR Paula Stefano Ivani de SI Delgado Artur Figueiredo AF Carvalho Werther Brunow de WB Duarte Nilo José Coelho NJC Morales Júnior Ronaldo R Santos Silvia Regina Cavani Jorge SRCJ

Revista Brasileira de terapia intensiva 20200701 3

<h4>Objective</h4>To investigate the vancomycin effectiveness against gram-positive pathogens with the minimum inhibitory concentration of 1mg/L in pediatric patients based on the area under the curve and the minimum inhibitory concentration ratio > 400.<h4>Methods</h4>A population of 22 pediatric patients (13 boys) admitted to the pediatric intensive care unit with preserved renal function was stratified in two groups (G1 < 7 years and G2 ≥ 7 years). After the fourth dose administered of vancom ...[more]

PMID: 33053028

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Does vancomycin administered at an empirical dose ensure coverage of pediatric patients against gram-positive pathogens?

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Does vancomycin administered at an empirical dose ensure coverage of pediatric patients against gram-positive pathogens?

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