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Related Experiment Videos

Vancomycin population pharmacokinetics in neonates.

M de Hoog1, R C Schoemaker, J W Mouton

  • 1Department of Pediatrics, Erasmus University and University Hospital Rotterdam/Sophia Children's Hospital, The Netherlands.

Clinical Pharmacology and Therapeutics
|May 9, 2000
PubMed
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A new vancomycin dosing schedule for neonates ensures therapeutic drug levels, eliminating the need for routine peak concentration monitoring. This optimized scheme benefits infants of all gestational ages.

Area of Science:

  • Neonatal pharmacokinetics
  • Infectious disease management

Background:

  • Recent debate on vancomycin therapeutic drug monitoring and ranges.
  • Need for updated dosing schemes for neonates based on new recommendations.

Purpose of the Study:

  • To develop an up-to-date vancomycin dosing scheme for neonates.
  • To incorporate new insights into vancomycin therapeutic ranges.

Main Methods:

  • Retrospective study with prospective validation of 108 newborns.
  • Population pharmacokinetic analysis using NONMEM software.
  • Simulation of various dosing schemes to achieve target trough (5-15 mg/L) and peak (<40 mg/L) concentrations.

Main Results:

  • Initial 30 mg/kg/day in two doses resulted in 34.3% trough and 17.6% peak concentrations outside the desired range.

Related Experiment Videos

  • A revised schedule of 30 mg/kg/day in three doses, irrespective of gestational age, was found optimal.
  • Prospective testing showed mean trough concentrations of 8.2 +/- 2.2 mg/L, with no peak levels exceeding 40 mg/L.

    • Conclusions:

    • The proposed three-dose vancomycin schedule achieves adequate trough serum concentrations in neonates.
    • Routine monitoring of peak vancomycin serum concentrations is not necessary with this optimized dosing scheme.