Evolution of empiric vancomycin dosing in a neonatal population

Area of Science:

• Neonatal pharmacology
• Infectious disease management

Background:

• Previous neonatal vancomycin empirical dosing (15-45 mg/kg/day) required assessment.
• A revised regimen (20-60 mg/kg/day) was developed based on initial effectiveness data.

Purpose of the Study:

• To validate the revised empirical vancomycin dosage regimen.
• To determine if the new regimen achieves target serum trough concentrations in neonates.

Main Methods:

• Multicenter retrospective before-and-after cohort study.
• Assessed proportion of neonates achieving target vancomycin troughs (<10, 10-20, >20 mg/L).
• Compared mean troughs and target achievement between historical and present cohorts.

Main Results:

• 63% of neonates in the present cohort achieved target vancomycin troughs.
• The revised regimen showed significantly higher mean troughs and target achievement rates (p<0.01).
• Fewer neonates had below-target levels compared to the historical cohort.

Conclusions:

• The revised empirical vancomycin dosing regimen is more effective.
• Achieving target serum trough concentrations is improved with the new dosing strategy.