Correlation of a Vancomycin Pharmacokinetic Model and Trough Serum Concentrations in Pediatric Patients

被引:18
|
作者
Ploessl, Cady [1 ,2 ]
White, Christopher [3 ]
Manasco, Kalen [1 ,2 ]
机构
[1] Georgia Regents Med Ctr, Dept Pharm, Augusta, GA USA
[2] Univ Georgia, Coll Pharm, Augusta, GA USA
[3] Georgia Regents Univ, Med Coll Georgia, Dept Pediat, Augusta, GA USA
关键词
vancomycin; area under the curve; pediatrics; Staphylococcus aureus; CHILDREN;
D O I
10.1097/INF.0000000000000817
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Vancomycin trough concentrations specific to pediatric patients have yet to be validated that achieve an area under the curve (AUC) over 24 hours to minimum inhibitory concentration (MIC) ratio >= 400. The primary objective of this study was to validate a pharmacokinetic model in a pediatric hospital and determine the correlation between a calculated AUC/MIC ratio and measured trough vancomycin concentration. Methods: A retrospective evaluation of patients aged 3 months to 18 years prescribed vancomycin at a pediatric hospital between January 2012 and June 2013. The correlation between patient-specific AUC/MIC and measured vancomycin trough concentration was assessed. Results: Forty pediatric patients with 40 vancomycin trough concentrations and documented Staphylococcus aureus cultures were included in the study. Median age was 8.5 (interquartile range, 2-14.3) years, median weight 28.7 (range, 14-50.2) kg, and mean baseline serum creatinine 0.51 +/- 0.3 mg/dL. The mean daily dose of vancomycin prescribed was 58 +/- 13.8 mg/kg/d. The mean vancomycin trough concentration was 11 +/- 5.5 mcg/mL, and the mean AUC/MIC was 534 +/- 373. No correlation was found between trough concentration and AUC/MIC (r(2) = 0.082, p = 0.07). Conclusions: This study validates the clinical applicability of a pharmacokinetic model for calculating vancomycin clearance to determine patient-specific AUC over 24 hours in pediatrics. Trough concentrations associated with proposed therapeutic AUC/MIC ratios were lower than reported in the adult population. Further research is needed to determine if AUC/MIC, trough concentration, or both is best for monitoring therapeutic efficacy of vancomycin in pediatrics.
引用
收藏
页码:E244 / E247
页数:4
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