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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

[Monitorization of blood levels of vancomycin in children with multi-resistant bacterial infections]

A G Reis1, S J Grisi

  • 1Pronto Socorro, Instituto da Criança, Hopsital das Clinicas, FMUSP, São Paulo, SP.

Jornal De Pediatria
|July 1, 1996
PubMed

Insights

Vancomycin dosing in children with resistant infections shows unpredictable serum concentrations. Therapeutic drug monitoring is crucial for effective vancomycin treatment in pediatric patients.

Area of Science:

  • Pediatric pharmacology
  • Infectious diseases
  • Clinical pharmacy

Context:

  • Vancomycin pharmacokinetics are less understood in pediatric populations compared to adults.
  • Multi-resistant bacterial infections pose a significant challenge in pediatric care.
  • Optimizing antibiotic therapy in children requires careful consideration of drug levels.

Purpose:

  • To investigate vancomycin serum concentrations in children with multi-resistant bacterial infections.
  • To assess the variability of vancomycin levels following standard dosing protocols in pediatric patients.
  • To evaluate the predictability of vancomycin pharmacokinetics in this specific demographic.

Summary:

  • Serum vancomycin concentrations were measured in 22 children receiving standard doses for multi-resistant infections.
  • Peak concentrations ranged widely (23-99 mcg/ml), with only 36% falling within the 30-40 mcg/ml target range.
  • Trough concentrations were observed between 5-10 mcg/ml in 45% of cases, indicating significant variability.

Impact:

  • These findings highlight the unpredictable nature of vancomycin pharmacokinetics in children.
  • The study underscores the necessity of therapeutic drug monitoring for vancomycin in pediatric patients.
  • Implementing routine blood level monitoring can improve treatment efficacy and patient outcomes.

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