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Describing vancomycin serum levels in pediatric intensive care unit (ICU) patients: are expected goals being met

BACKGROUND: In the pediatric population, infections by methicillin-resistant Staphylococcus aureus (MRSA) are associated with significant morbidity and hospital costs. Vancomycin is a glycopeptide antibiotic, widely used for the treatment of serious infections by Gram-positive microorganisms, especi...

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Autores principales: Maloni, Talita Muniz, Belucci, Talita Rantin, Malagutti, Sandra Regina, Furtado, Guilherme Henrique Campos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6639923/
https://www.ncbi.nlm.nih.gov/pubmed/31319831
http://dx.doi.org/10.1186/s12887-019-1602-8
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author Maloni, Talita Muniz
Belucci, Talita Rantin
Malagutti, Sandra Regina
Furtado, Guilherme Henrique Campos
author_facet Maloni, Talita Muniz
Belucci, Talita Rantin
Malagutti, Sandra Regina
Furtado, Guilherme Henrique Campos
author_sort Maloni, Talita Muniz
collection PubMed
description BACKGROUND: In the pediatric population, infections by methicillin-resistant Staphylococcus aureus (MRSA) are associated with significant morbidity and hospital costs. Vancomycin is a glycopeptide antibiotic, widely used for the treatment of serious infections by Gram-positive microorganisms, especially MRSA. It is recommended to keep the serum level of vancomycin between 10 and 20 mg/L, that correlates with AUC/MIC > 400 in adults. This pharmacodynamic target is extrapolated to pediatric patients despite the lack of similar evidence. However, recent studies suggest that serum levels between 7 and 10 mg/L are predictive of reaching the pharmacodynamic target in this population. In spite of widespread use, ideal information about dosage for the pediatric population remains limited. METHODS: A retrospective study was conducted in patients admitted to the Pediatric Intensive Care Unit during the period between January 01, 2008 to December 31, 2014. We investigated variables such as age, positive fluid balance and use of vasoactive drugs on the ability of these patients to achieve the proposed recommended serum level target and the vancomycin serum levels. RESULTS: Our study showed that only 26% of children reached the 10–20 mg/L serum level whereas the 7–20 mg/L serum level was reached by 51% of patients. CONCLUSIONS: We observed no evidence of a significant association between the inadequacy of serum level and age. The positive fluid balance also had no influence on the vancomycin serum level but patients using vasoactive drugs had a greater serum level adequacy than patients not using vasoactive drugs.
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spelling pubmed-66399232019-07-29 Describing vancomycin serum levels in pediatric intensive care unit (ICU) patients: are expected goals being met Maloni, Talita Muniz Belucci, Talita Rantin Malagutti, Sandra Regina Furtado, Guilherme Henrique Campos BMC Pediatr Research Article BACKGROUND: In the pediatric population, infections by methicillin-resistant Staphylococcus aureus (MRSA) are associated with significant morbidity and hospital costs. Vancomycin is a glycopeptide antibiotic, widely used for the treatment of serious infections by Gram-positive microorganisms, especially MRSA. It is recommended to keep the serum level of vancomycin between 10 and 20 mg/L, that correlates with AUC/MIC > 400 in adults. This pharmacodynamic target is extrapolated to pediatric patients despite the lack of similar evidence. However, recent studies suggest that serum levels between 7 and 10 mg/L are predictive of reaching the pharmacodynamic target in this population. In spite of widespread use, ideal information about dosage for the pediatric population remains limited. METHODS: A retrospective study was conducted in patients admitted to the Pediatric Intensive Care Unit during the period between January 01, 2008 to December 31, 2014. We investigated variables such as age, positive fluid balance and use of vasoactive drugs on the ability of these patients to achieve the proposed recommended serum level target and the vancomycin serum levels. RESULTS: Our study showed that only 26% of children reached the 10–20 mg/L serum level whereas the 7–20 mg/L serum level was reached by 51% of patients. CONCLUSIONS: We observed no evidence of a significant association between the inadequacy of serum level and age. The positive fluid balance also had no influence on the vancomycin serum level but patients using vasoactive drugs had a greater serum level adequacy than patients not using vasoactive drugs. BioMed Central 2019-07-18 /pmc/articles/PMC6639923/ /pubmed/31319831 http://dx.doi.org/10.1186/s12887-019-1602-8 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Maloni, Talita Muniz
Belucci, Talita Rantin
Malagutti, Sandra Regina
Furtado, Guilherme Henrique Campos
Describing vancomycin serum levels in pediatric intensive care unit (ICU) patients: are expected goals being met
title Describing vancomycin serum levels in pediatric intensive care unit (ICU) patients: are expected goals being met
title_full Describing vancomycin serum levels in pediatric intensive care unit (ICU) patients: are expected goals being met
title_fullStr Describing vancomycin serum levels in pediatric intensive care unit (ICU) patients: are expected goals being met
title_full_unstemmed Describing vancomycin serum levels in pediatric intensive care unit (ICU) patients: are expected goals being met
title_short Describing vancomycin serum levels in pediatric intensive care unit (ICU) patients: are expected goals being met
title_sort describing vancomycin serum levels in pediatric intensive care unit (icu) patients: are expected goals being met
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6639923/
https://www.ncbi.nlm.nih.gov/pubmed/31319831
http://dx.doi.org/10.1186/s12887-019-1602-8
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