Vancomycin efficiency and safety of a dosage of 40-60 mg/kg/d and corresponding trough concentrations in children with Gram-positive bacterial sepsis.
Gram-positive bacterial
children
dosages
tough concentrations
vancomycin
Journal
Frontiers in cellular and infection microbiology
ISSN: 2235-2988
Titre abrégé: Front Cell Infect Microbiol
Pays: Switzerland
ID NLM: 101585359
Informations de publication
Date de publication:
2023
2023
Historique:
received:
06
12
2022
accepted:
20
03
2023
medline:
18
4
2023
entrez:
17
4
2023
pubmed:
18
4
2023
Statut:
epublish
Résumé
Optimal vancomycin trough concentrations and dosages remain controversial in sepsis children. We aim to investigate vancomycin treatment outcomes with a dosage of 40-60 mg/kg/d and corresponding trough concentrations in children with Gram-positive bacterial sepsis from a clinical perspective. Children diagnosed with Gram-positive bacterial sepsis and received intravenous vancomycin therapy between January 2017 and June 2020 were enrolled retrospectively. Patients were categorized as success and failure groups according to treatment outcomes. Laboratory, microbiological, and clinical data were collected. The risk factors for treatment failure were analyzed by logistic regression. In total, 186 children were included, of whom 167 (89.8%) were enrolled in the success group and 19 (10.2%) in the failure group. The initial and mean vancomycin daily doses in failure group were significantly higher than those in success group [56.9 (IQR =42.1-60.0) Vancomycin dosages of 40-60 mg/kg/d are effective and have no vancomycin-related nephrotoxicity adverse effects in children with Gram-positive bacterial sepsis. Vancomycin trough concentrations >15 mg/L are not an essential target for these Gram-positive bacterial sepsis patients. PRISM III scores ≥10 may serve as an independent risk factor for vancomycin treatment failure in these patients.
Sections du résumé
Background
Optimal vancomycin trough concentrations and dosages remain controversial in sepsis children. We aim to investigate vancomycin treatment outcomes with a dosage of 40-60 mg/kg/d and corresponding trough concentrations in children with Gram-positive bacterial sepsis from a clinical perspective.
Methods
Children diagnosed with Gram-positive bacterial sepsis and received intravenous vancomycin therapy between January 2017 and June 2020 were enrolled retrospectively. Patients were categorized as success and failure groups according to treatment outcomes. Laboratory, microbiological, and clinical data were collected. The risk factors for treatment failure were analyzed by logistic regression.
Results
In total, 186 children were included, of whom 167 (89.8%) were enrolled in the success group and 19 (10.2%) in the failure group. The initial and mean vancomycin daily doses in failure group were significantly higher than those in success group [56.9 (IQR =42.1-60.0)
Conclusions
Vancomycin dosages of 40-60 mg/kg/d are effective and have no vancomycin-related nephrotoxicity adverse effects in children with Gram-positive bacterial sepsis. Vancomycin trough concentrations >15 mg/L are not an essential target for these Gram-positive bacterial sepsis patients. PRISM III scores ≥10 may serve as an independent risk factor for vancomycin treatment failure in these patients.
Identifiants
pubmed: 37065209
doi: 10.3389/fcimb.2023.1117717
pmc: PMC10098341
doi:
Substances chimiques
Vancomycin
6Q205EH1VU
Anti-Bacterial Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1117717Informations de copyright
Copyright © 2023 Peng, Guo, Zhang, Tian, Gu, Li, Li and Luo.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Pediatr Infect Dis J. 2013 Oct;32(10):1077-9
pubmed: 23652479
Int J Antimicrob Agents. 2021 Mar;57(3):106300
pubmed: 33567334
Int J Infect Dis. 2020 Mar;92:151-159
pubmed: 31935538
Front Public Health. 2014 Oct 31;2:217
pubmed: 25401098
J Clin Med. 2022 Jun 23;11(13):
pubmed: 35806919
Crit Care Med. 1996 May;24(5):743-52
pubmed: 8706448
Lancet Respir Med. 2018 Mar;6(3):223-230
pubmed: 29508706
JAMA. 2020 Feb 11;323(6):527-537
pubmed: 32044943
Br J Clin Pharmacol. 2019 Nov;85(11):2591-2598
pubmed: 31378957
J Pediatric Infect Dis Soc. 2015 Dec;4(4):e109-16
pubmed: 26582878
Clin Infect Dis. 2020 Sep 12;71(6):1361-1364
pubmed: 32658968
J Antimicrob Chemother. 2020 Apr 1;75(4):1038-1046
pubmed: 31919504
Antimicrob Agents Chemother. 2018 Jan 25;62(2):
pubmed: 29133561
J Clin Pharmacol. 2017 Jan;57(1):77-84
pubmed: 27291466
Int J Antimicrob Agents. 2008 Oct;32(4):294-301
pubmed: 18621508
Antimicrob Agents Chemother. 2017 Nov 22;61(12):
pubmed: 28923869
Infect Drug Resist. 2016 Oct 14;9:243-252
pubmed: 27789965
Expert Opin Drug Saf. 2019 Sep;18(9):795-802
pubmed: 31305171
Sci Rep. 2018 May 18;8(1):7868
pubmed: 29777150
Ther Drug Monit. 2016 Feb;38(1):120-6
pubmed: 26418699
Paediatr Drugs. 2018 Apr;20(2):153-164
pubmed: 29344778
Clin Infect Dis. 2021 Oct 5;73(7):e1579-e1586
pubmed: 33382398
Nephron Clin Pract. 2012;120(4):c179-84
pubmed: 22890468
Intensive Care Med. 2020 Feb;46(Suppl 1):10-67
pubmed: 32030529
Antimicrob Agents Chemother. 2019 Jun 24;63(7):
pubmed: 31010862
Pharmacotherapy. 2013 Dec;33(12):1273-7
pubmed: 23798327
Clin Infect Dis. 2019 Jan 18;68(3):365-372
pubmed: 29893805
Pharmacotherapy. 2015 Mar;35(3):337-43
pubmed: 25756622
Clin Infect Dis. 2018 Nov 13;67(suppl_2):S249-S255
pubmed: 30423040
Pediatrics. 2013 Sep;132(3):e756-67
pubmed: 23940245
Pharmacotherapy. 2013 Apr;33(4):392-400
pubmed: 23471688
Microb Drug Resist. 2020 Mar;26(3):218-226
pubmed: 31424323
Ann Transl Med. 2021 Feb;9(3):224
pubmed: 33708851
Int J Clin Pharm. 2021 Oct;43(5):1394-1403
pubmed: 33913087
Clin Infect Dis. 2011 Feb 1;52(3):e18-55
pubmed: 21208910