Actual body weight-based vancomycin dosing in neonates
Language English Country Great Britain, England Media print-electronic
Document type Journal Article, Observational Study
- Keywords
- Dosing nomogram, Neonates, Pharmacokinetics, Sepsis, Therapeutic drug monitoring, Vancomycin,
- MeSH
- Anti-Bacterial Agents administration & dosage pharmacokinetics MeSH
- Humans MeSH
- Drug Monitoring MeSH
- Nomograms MeSH
- Infant, Newborn MeSH
- Sepsis drug therapy MeSH
- Body Weight MeSH
- Vancomycin administration & dosage pharmacokinetics MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Infant, Newborn MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Names of Substances
- Anti-Bacterial Agents MeSH
- Vancomycin MeSH
This study aimed to explore vancomycin pharmacokinetics and its covariates in critically ill neonates and to propose an easy applicable dosing nomogram for initial treatment. Individual vancomycin pharmacokinetic parameters were calculated based on therapeutic drug monitoring data using a one-compartmental model. A linear regression model was used for examination of covariates. The mean (SD) volume of distribution (Vd) and clearance (CL) for vancomycin were 0.73 (0.31) L/kg and 0.052 (0.020) L/h/kg, respectively. Vd was related to actual body weight (ABW), gestational and postmenstrual age. CL was also associated with ABW, gestational, postmenstrual age and also creatinine clearance. ABW was the strongest predictor for vancomycin pharmacokinetics and consequently dosing. Loading dose (mg) of 11.81 × ABW (kg) + 7.86 and maintenance dose (mg/day) of 40.92 × ABW (kg) -22.18 most closely approximated pharmacokinetic target. Vancomycin pharmacokinetics was mainly influenced by ABW in neonates and a practical ABW-based dosing algorithm was developed.
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