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Pharmacokinetics of vancomycin in neonates admitted to the neonatology unit at the Jordan University Hospital
- Source :
- International journal of clinical pharmacology and therapeutics. 49(4)
- Publication Year :
- 2011
-
Abstract
- BACKGROUND Vancomycin is used in neonatal intensive care units to treat nosocomial infections caused by methicillin-resistant Staphylococcus aureus (MRSA) or coagulase-negative staphylococci. Current dosing regimens are not adequate, producing trough concentrations below the target range. PATIENTS AND METHODS 151 neonates who received vancomycin and had vancomycin peak and trough concentration measurements as part of regular therapeutic drug monitoring were utilized. The patients were divided into three groups according to gestational age; less than 28 weeks, 28 to less than 34 weeks and 34 weeks to term. Neonates were given vancomycin doses as per guidelines. The pharmacokinetic parameters, elimination rate constant (K), elimination half-life (t1/2), volume of distribution (VD) and clearance (CL), were calculated. RESULTS Peak vancomycin concentrations ranged from 9.4 to 52.8 mg/l, while troughs ranged from 0.0 to 16.6 mg/l. One third of the trough concentrations were below 5 mg/l and are thus, subtherapeutic. There were no statistically significant differences between the three groups in regard to elimination rate constant and half-life. However, there was a statistically significant difference in volume of distribution between the three groups (p < 0.05), and in clearance between the first group and the other two (p < 0.05), using Kruskal-Wallis statistical test. CONCLUSIONS The empirical dosing method used was inadequate in one third of patients. Individualization of vancomycin dosing in the neonatal critical care unit at The Jordan University Hospital seems necessary.
- Subjects :
- Male
Pediatrics
medicine.medical_specialty
Gestational Age
law.invention
Hospitals, University
Elimination rate constant
law
Vancomycin
Intensive care
Intensive Care Units, Neonatal
medicine
Humans
Pharmacology (medical)
Trough Concentration
Dosing
Pharmacology
Volume of distribution
Jordan
medicine.diagnostic_test
business.industry
Infant, Newborn
Intensive care unit
Anti-Bacterial Agents
Therapeutic drug monitoring
Anesthesia
Linear Models
Female
Drug Monitoring
business
medicine.drug
Subjects
Details
- ISSN :
- 09461965
- Volume :
- 49
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- International journal of clinical pharmacology and therapeutics
- Accession number :
- edsair.doi.dedup.....e20d0046b050705510f800072f09fccd