Abstract Objective To analyze serum vancomycin concentration after administration of different therapeutic doses in children with Staphylococcus aureus pneumonia (SAP) in order to determine the appropriate dose of vancomycin in clinical administration. Methods The clinical data of 35 children who were diagnosed with SAP and treated with vancomycin from January 2008 to December 2013 were retrospectively analyzed. Results Among the 35 SAP cases with vancomycin therapy, 22 cases (63%) had serum vancomycin trough concentration monitored. The numbers of cases with vancomycin at 10, 12.5, and 15 mg/(kg·dose) × every 6 hours (q6h) were 11, 4 and 7, respectively. The mean serum trough concentration of vancomycin in the 15 mg/(kg·dose) group was 14.98 mg/L, which was significantly higher than in the 10 mg/(kg·dose) and 12.5 mg/(kg·dose) groups (4.97 and 8.00 mg/L respectively; P<0.05). The percentage of cases that reached the expected trough concentration in the 15 mg/(kg·dose) group (71%) was significantly higher than that in the 10 mg/(kg·dose) group (9%), but there was no significant difference in this percentage between the 15 mg/(kg·dose) and 12.5 mg/(kg·dose) groups (71% vs 25%). Conclusions The reasonable dosage of vancomycin for the treatment of pediatric SAP is 15 mg/(kg·dose) × q6h or 60 mg/(kg·d).
ZHANG Guang-Li,ZHAMG Hui,LIU Ru et al. Analysis of serum vancomycin concentration after administration of different doses in children with Staphylococcus aureus pneumonia[J]. CJCP, 2014, 16(10): 984-987.
ZHANG Guang-Li,ZHAMG Hui,LIU Ru et al. Analysis of serum vancomycin concentration after administration of different doses in children with Staphylococcus aureus pneumonia[J]. CJCP, 2014, 16(10): 984-987.
Liu C, Bayer A, Cosgrove SE, et a1. Clinical practice guidelinesby the infectious diseases society of America for the treatmentof methicillin-resistant Staphylococcus aureus infections inadultsand children[J]. Clin Infect Dis, 2011, 52(3): 285-292.
Avent ML, Vaska VL, Rogers BA, et al. Vancomycintherapeutics and monitoring: a contemporary approach[J]. InternMed J, 2013, 43(2): 110-119.
[9]
Sanchez JZ, Dominguez AR, Lane JR, et al. Populationpharmacokinetics of vancomycin in adult and geriatric patients:comparison of eleven approaches[J]. Int J Clin Pharmacol Ther,2010, 48(8): 525-533.
[10]
Pea F, Bertolissi M, Di Silvestre A, et al. TDM coupled withBayesian forecasting should be considered an invaluable tool foroptimizing vancomycin daily exposure in unstable critically illpatients [J]. Int J Antimicrob Agents, 2002, 20(5): 326-332.
[11]
Nunn MO, Corallo CE, Aubron C, et al. Vancomycin dosing:assessment of time to therapeutic concentration and predictiveaccuracy of phmrmacokinetic modeling software[J]. AnnPharmacother, 2011, 45(6): 757-763.
[12]
Hiraki Y, Onga T, Mizoguchi A, et al. Investigation of theprediction accuracy of vancomycin concentrations determinedby patient-specific parameters as estimated by Bayesiananalysis[J]. J Clin Pharm Ther, 2010, 35(5): 527-532.
McKamy S, Hernandez E, Jahng M, et al. Incidence andrisk factors influencing the development of vancomycinnephrotoxicity in children[J]. J Pediatr, 2011, 158(3): 422-426.
[17]
Chen Y, Yang XY, Zeckel M, et al. Risk of hepatic events inpatients with vancomycin in clinical studies: a systematic reviewand meta-analysis[J]. Drug Saf, 2011, 34(1): 73-82.