Association of Initial Trough Concentrations of Vancomycin with Outcomes in Pediatric Patients with Gram-Positive Bacterial Infection

Vancomycin is a glycopeptide antibiotic used for the treatment of Gram-positive infections. For adult patients, treatment with vancomycin requires effective therapeutic drug-monitoring (TDM) to achieve clinical outcomes and reduce the incidence of adverse effects. However, it remains still unclear w...

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Bibliographic Details
Published in:Biological & pharmaceutical bulletin 2020/10/01, Vol.43(10), pp.1463-1468
Main Authors: Kondo, Miko, Nakagawa, Shunsaku, Orii, Satoru, Itohara, Kotaro, Sugimoto, Mitsuhiro, Omura, Tomohiro, Sato, Yuki, Imai, Satoshi, Yonezawa, Atsushi, Nakagawa, Takayuki, Matsubara, Kazuo
Format: Article
Language:English
Subjects:
Antibiotics
Body weight
C-reactive protein
Clinical outcomes
Fever
Glomerular filtration rate
Glycopeptides
Gram-positive infection
Patients
Pediatrics
therapeutic drug monitoring
Vancomycin
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Summary:Vancomycin is a glycopeptide antibiotic used for the treatment of Gram-positive infections. For adult patients, treatment with vancomycin requires effective therapeutic drug-monitoring (TDM) to achieve clinical outcomes and reduce the incidence of adverse effects. However, it remains still unclear whether the TDM with vancomycin is beneficial in yielding better clinical outcomes in pediatrics. The objective of our study was to evaluate whether the clinical response to treatment was associated with initial trough concentrations of vancomycin in pediatric patients. A retrospective observation study of 60 patients (age: 1 month–15 years) who had completed and qualified for analysis was conducted at Kyoto University Hospital. The response to treatment was assessed by the time to resolution of fever and time to 50% decline in C-reactive protein (CRP). In addition, we explored whether vancomycin trough level was associated with the baseline characteristics. Trend analysis showed that there were significant correlations between vancomycin trough level and age, body weight, estimated glomerular filtration rate, and serum albumin levels. The time to resolution of fever of the patients with higher initial trough level (≥ 5 µg/mL) was significantly lower than that of the patients with lower trough level (
ISSN:0918-6158
1347-5215
DOI:10.1248/bpb.b19-01003