Related Experiment Video

Updated: May 8, 2026

A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically
11:28

A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically

Published on: September 9, 2015

Vancomycin dosing in children: what is the question?

Theresa S Cole1, Andrew Riordan

  • 1Department of Infectious Disease and Immunology, Alder Hey Children's NHS Foundation Trust, , Liverpool, UK.

Archives of Disease in Childhood
|August 20, 2013
PubMed

Insights

Optimizing vancomycin dosing in children is crucial. Current recommendations for higher trough levels may not be necessary for all infections, suggesting a need for revised pediatric dosing guidelines.

Area of Science:

  • Pediatric Pharmacology
  • Infectious Diseases
  • Antimicrobial Stewardship

Background:

  • Vancomycin has been used for over 60 years, but optimal pediatric dosing remains unclear.
  • Effective vancomycin treatment requires achieving a target area under the concentration curve (AUC)/minimum inhibitory concentration (MIC) ratio >400.
  • Rising staphylococcal MICs have led to recommendations for higher vancomycin trough levels (15-20 mg/L) in children.

Purpose of the Study:

  • To evaluate the current vancomycin dosing strategies in pediatric patients.
  • To determine if higher trough levels are universally necessary for effective vancomycin treatment in children.
  • To propose a standardized vancomycin dosing regimen for pediatric populations.

Main Methods:

  • Review of pharmacokinetic and modeling studies in children.
  • Analysis of current clinical practices and their outcomes.
  • Assessment of the impact of bacterial MIC on vancomycin efficacy.

Main Results:

  • Most children currently do not achieve the recommended higher vancomycin trough levels.
  • Pharmacokinetic data suggest higher trough levels may not be required when the organism's MIC is ≤1 mg/L.
  • Limited evidence exists for the use of loading doses or continuous vancomycin infusions in pediatric patients.

Conclusions:

  • A standard starting regimen of vancomycin at 15 mg/kg every 6 hours should be considered for children.
  • Determining the MIC of the infecting organism is vital for guiding appropriate vancomycin trough level targets.
  • Further large-scale studies are needed to establish definitive pediatric vancomycin dosing guidelines.

Keywords:
Infectious DiseasesMicrobiologyPharmacology

More Related Videos

A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials06:18

A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials

Published on: March 3, 2023

Related Concept Videos

Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Estimation of k and VD of Aminoglycosides01:20

Estimation of k and VD of Aminoglycosides

Aminoglycosides are a class of antibiotics used to treat various bacterial infections. Clinicians must determine the elimination rate constant (k) and volume of distribution (VD) to optimize therapeutic efficacy and minimize toxicity. The k value represents the rate at which the drug is removed from the body, and the VD reflects the degree to which the drug distributes into body tissues. Accurately estimating these parameters allows healthcare professionals to tailor drug dosing to individual...
Dosage Interval and Administration Route: Determination Methods01:19

Dosage Interval and Administration Route: Determination Methods

A medication’s effectiveness largely depends on its appropriate dosage and the route of administration. Dosage ensures that a sufficient drug concentration is maintained in the bloodstream to elicit the desired therapeutic effect without causing toxicity. The route of administration affects the drug's bioavailability, rate of absorption, and onset of action, which are crucial for achieving optimal therapeutic outcomes. Drug dosage calculations are critical to tailoring therapy to individual...
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...