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Efficacy and Safety of Continuous Infusion of Vancomycin in Children: A Systematic Review

Marta Alonso-Moreno1, Marta Mejías-Trueba1, Laura Herrera-Hidalgo2

  • 1Unidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío, 41013 Seville, Spain.

Antibiotics (Basel, Switzerland)
|August 27, 2021
PubMed

Insights

Continuous infusion vancomycin (CIV) shows potential pharmacokinetic benefits in children, but more research is needed to confirm its efficacy and safety compared to intermittent infusion vancomycin (IIV). Optimal pediatric dosing remains unclear.

Area of Science:

  • Pediatric Infectious Diseases
  • Pharmacokinetics and Pharmacodynamics
  • Antimicrobial Stewardship

Background:

  • Vancomycin is a critical antibiotic for pediatric infections.
  • Continuous infusion vancomycin (CIV) is explored as an alternative to intermittent infusion vancomycin (IIV) in adults, with potential benefits.
  • The use of CIV in pediatric patients is increasing, but evidence is limited.

Purpose of the Study:

  • To review and synthesize available evidence on the efficacy and safety of continuous infusion vancomycin (CIV) in the pediatric population.
  • To identify gaps in current research regarding CIV use in children.

Main Methods:

  • Systematic literature review following PRISMA guidelines.
  • Bibliographic search of PubMed and EMBASE databases.
  • Inclusion of clinical trials and observational studies reporting on pediatric CIV efficacy and/or target attainment.

Main Results:

  • Seven studies met inclusion criteria out of 359 identified articles.
  • All included studies evaluated target attainment; six assessed safety.
  • Only three studies assessed clinical efficacy, indicating a significant evidence gap.
  • Current data suggests potential pharmacokinetic advantages for CIV in pediatrics.

Conclusions:

  • The optimal vancomycin administration method for pediatric patients remains undetermined due to limited clinical efficacy and safety data.
  • Further comparative studies investigating intermittent infusion vancomycin (IIV) versus continuous infusion vancomycin (CIV) are necessary.
  • Research should focus on clinical efficacy and toxicity outcomes to guide pediatric vancomycin dosing strategies.

Keywords:
childrencontinuousinfusionpediatricsvancomycin

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