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Title: Optimization of Vancomycin Dosing in Very Low-Birth-Weight Preterm Neonates
Authors: Madigan, T.
Teng, C.B. 
Koshaish, J.
Johnson, K.R.
Graner, K.K.
Banerjee, R.
Keywords: neonates
Issue Date: 2014
Citation: Madigan, T., Teng, C.B., Koshaish, J., Johnson, K.R., Graner, K.K., Banerjee, R. (2014). Optimization of Vancomycin Dosing in Very Low-Birth-Weight Preterm Neonates. American Journal of Perinatology. ScholarBank@NUS Repository.
Abstract: Objective To compare vancomycin serum trough concentrations and 24-hour area under the serum concentration-versus-time curve (AUC24) among very low-birth-weight (VLBW) premature infants before and after implementation of an institution-wide increase in neonatal vancomycin dosing. Study Design We performed a retrospective analysis of vancomycin concentrations among preterm VLBW neonates before (2007-2010) and after (2010-2013) implementation of a new vancomycin dosing protocol consisting of increased vancomycin daily dose and frequency of administration. Results Neonates weighing < 1,500 g and receiving the new vancomycin dosing regimen had lower rates of undetectable trough concentrations (24 vs. 50%, p = 0.04), higher median trough concentrations (10.8 vs. 5.9 μg/mL, p = 0.003), a higher proportion of goal trough concentrations of 10 to 20 μg/mL (35 vs. 4%, p = 0.005), and a significantly higher vancomycin AUC24 (438 vs. 320 mg·h/L, p = 0.004) compared with historical controls. Conclusion Increasing the vancomycin daily dose and dosing frequency led to an increase in vancomycin trough concentrations and AUC24, and a decrease in the proportion of undetectable (< 5.0 μg/mL) troughs, without an increase in toxicity among VLBW premature neonates. © Thieme Medical Publishers.
Source Title: American Journal of Perinatology
ISSN: 07351631
DOI: 10.1055/s-0034-1376183
Appears in Collections:Staff Publications

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