© 2002 Archives of Disease in Childhood Fetal and Neonatal Edition
ORIGINAL ARTICLE
Dose regimen for vancomycin not needing serum peak levels?
1 Neonatal Intensive Care Unit, The Rosie Hospital, Box 226, Addenbrookes NHS Trust, Cambridge CB2 2QQ, UK
2 Department of Clinical Microbiology and Public Health Laboratory, Box 236, Addenbrookes NHS Trust
Correspondence to:
Correspondence to:
Dr McClure, Neonatal Intensive Care Unit, The Rosie Hospital, Box 226, Addenbrookes NHS Trust, Cambridge CB2 2QQ, UK;
rob.mcclure{at}msexc.addenbrookes.anglox.nhs.uk
Aim: To determine the safety, efficacy, and need to measure peak serum vancomycin concentrations in a neonatal population using a standard vancomycin dosage regimen.
Method: A total of 101 infants who were admitted to a regional neonatal intensive care unit and received vancomycin (15 mg/kg every 12 or 18 hours depending on postnatal age) were studied retrospectively. Infants who had been started on vancomycin before they were transferred to the unit were excluded. The proportion of infants was measured whose serum vancomycin concentrations were within a conservative therapeutic range of trough 510 mg/l, peak 2040 mg/l, and a less conservative, but still safe, range of trough 512 mg/l, peak 1560 mg/l.
Results: Trough concentrations of 510 mg/l were achieved by 46.5% of infants, and 512 mg/l by 55.4%. Peak concentrations of 2040 mg/l were found in 83.2% of infants, and 1560 mg/l in 99.0%. Highest peak concentration was 47.2 mg/l. Some 89.4% of infants with trough concentrations of 510 mg/l had a peak concentration of 2040 mg/l.
Conclusions: The vancomycin dosage regimen used in this study produces acceptable therapeutic serum vancomycin concentrations. Peak serum vancomycin concentrations do not need to be measured in neonates using this dosage regimen.
Keywords: vancomycin; drug monitoring; dosage regimen; sepsis; toxicity
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eLetters:
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- Role of serum peak levels of vancomycin in NICUs
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