Related Experiment Video
Updated: Dec 25, 2025
A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically
Published on: September 9, 2015
Should the Vancomycin Minimal Inhibitory Concentration be used as an Infant Critical Care Regular Criteria?
Nadielle S Bidu1, Bruno J D Fernandes2, Jucelino N C Filho1
1Pharmacy Postgraduate Program, Faculty of Pharmacy, Federal University of Bahia/UFBA, Salvador, Bahia, Brazil.
Background:
Vancomycin is the first-line antibiotic used for the treatment of staphylococcal infections. Because of its narrow therapeutic window and the pharmacokinetics variability, vancomycin trough serum concentration should be monitored. However, due to the increased cases of staphylococcus' commensal species infections and the case of vancomycin resistance, the minimal inhibitory concentration should be considered on antimicrobial therapy.
Objective:
This article aimed to show the importance of the minimal inhibitory concentration to infants on vancomycin therapy as regular criteria.
Materials And Methods:
Three infants in the use of vancomycin, hospitalized in the same maternity hospital, and that had at least one blood culture performed during the intensive-care-unit hospitalization were included in the study. Vancomycin serum concentrations were determined by particleenhanced- turbidimetric inhibition-immunoassay. The vancomycin minimal inhibitory concentration data were interpreted by following the Clinical and Laboratory Standards Institute (CLSI) and the European Committee on Antimicrobial Susceptibility Testing (EUCAST). The trough serum concentration range of 10 to 20 mg.L-1 was considered therapeutic.
Results:
All three patients had at least one infection by S. epidermidis, being one patient exhibit vancomycin- resistant S. epidermidis infection. All patients had stoppages in the vancomycin treatment, and the minimal inhibitory concentration was performed for only one patient.
Conclusion:
The data obtained from these patients also showed the need to perform therapeutic monitoring by using minimal inhibitory concentration values, because, although the serum concentrations were within the reference range, they are insufficient to guarantee patient therapeutic success.
Insights
Monitoring vancomycin therapy in infants requires considering minimal inhibitory concentration (MIC) alongside serum levels. This is crucial due to rising vancomycin resistance and variable patient responses, ensuring effective treatment outcomes.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Pharmacology
- Antimicrobial Stewardship
Background:
- Vancomycin is a critical antibiotic for staphylococcal infections but has a narrow therapeutic window.
- Pharmacokinetic variability necessitates monitoring vancomycin trough serum concentrations.
- Increasing vancomycin resistance and infections by staphylococcal commensal species highlight the need to consider minimal inhibitory concentration (MIC).
Purpose of the Study:
- To emphasize the importance of minimal inhibitory concentration (MIC) in guiding vancomycin therapy for infants.
- To advocate for MIC as a standard criterion in pediatric vancomycin treatment protocols.
Main Methods:
- Study included three infants receiving vancomycin in a single maternity hospital.
- Vancomycin serum concentrations were measured using particle-enhanced turbidimetric immunoassay.
- MIC data were interpreted according to CLSI and EUCAST guidelines; a trough serum concentration of 10-20 mg/L was considered therapeutic.
Main Results:
- All three infants had Staphylococcus epidermidis infections; one developed vancomycin-resistant S. epidermidis.
- Vancomycin treatment was discontinued in all patients.
- Minimal inhibitory concentration (MIC) was determined for only one patient.
Conclusions:
- Therapeutic drug monitoring using minimal inhibitory concentration (MIC) is essential for vancomycin therapy in infants.
- Serum concentrations alone, even within the therapeutic range, may not guarantee successful treatment outcomes.
- The study underscores the need for a comprehensive approach to vancomycin monitoring, incorporating MIC values.
More Related Videos
12:03Antimicrobial Synergy Testing by the Inkjet Printer-assisted Automated Checkerboard Array and the Manual Time-kill Method
Published on: April 18, 2019
09:57System for Efficacy and Cytotoxicity Screening of Inhibitors Targeting Intracellular Mycobacterium tuberculosis
Published on: April 5, 2017
Related Concept Videos
01:15Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:20Estimation of k and VD of Aminoglycosides
01:29Drug Dosing: Infants and Children
01:19Dosage Interval and Administration Route: Determination Methods