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Continuous Infusion Vancomycin in Pediatric Patients: A Critical Review of the Evidence

Heather L Girand

    The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
    |April 9, 2020
    PubMed

    Insights

    Continuous infusion vancomycin in pediatric patients lacks evidence for routine use. It may benefit select patients with serious infections needing rapid target serum concentrations or those with suboptimal responses to intermittent dosing.

    Area of Science:

    • Pharmacology
    • Pediatric Infectious Diseases
    • Drug Administration

    Background:

    • Vancomycin is commonly administered via intermittent infusions.
    • Continuous infusion is an alternative method to achieve target serum concentrations.
    • Evidence for its use in pediatric patients is limited.

    Purpose of the Study:

    • To evaluate the efficacy and safety of continuous infusion vancomycin in pediatric patients.
    • To review existing literature on continuous infusion vancomycin in pediatrics.

    Main Methods:

    • A comprehensive literature search was conducted in PubMed, Cochrane Library, International Pharmaceutical Abstracts, and Google Scholar.
    • Included English-language primary references from 1977 to November 2019 evaluating continuous infusion vancomycin in pediatric patients.
    • Search terms included vancomycin, pediatrics, infusion, continuous, administration, and related pharmacokinetic/pharmacodynamic terms.

    Main Results:

    • Fifteen articles were reviewed, showing heterogeneous data.
    • Limited evidence supports improved clinical or microbiologic outcomes compared to intermittent dosing.
    • Potential benefits and limitations of continuous infusions were discussed.

    Conclusions:

    • Routine implementation of continuous infusion vancomycin in pediatric patients is not currently supported by sufficient evidence.
    • It may be a valuable option for specific clinical scenarios, such as severe Gram-positive infections requiring rapid target concentration achievement.
    • Further prospective randomized trials are needed to establish optimal dosing, monitoring, and comparative efficacy/safety in pediatric populations.
    Abstract

    Keywords:
    administrationcontinuous infusionintermittentneonatepediatricsvancomycinvancomycin infusion

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