HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Read responses to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in ADC Online Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tan, W-H Articles by McClure, R J Search for Related Content PubMed PubMed Citation Articles by Tan, W-H Articles by McClure, R J

Dose regimen for vancomycin not needing serum peak levels?

¹ Neonatal Intensive Care Unit, The Rosie Hospital, Box 226, Addenbrooke’s NHS Trust, Cambridge CB2 2QQ, UK
² Department of Clinical Microbiology and Public Health Laboratory, Box 236, Addenbrooke’s NHS Trust

Correspondence to:
Correspondence to:
Dr McClure, Neonatal Intensive Care Unit, The Rosie Hospital, Box 226, Addenbrooke’s 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 5–10 mg/l, peak 20–40 mg/l, and a less conservative, but still safe, range of trough 5–12 mg/l, peak 15–60 mg/l.

Results: Trough concentrations of 5–10 mg/l were achieved by 46.5% of infants, and 5–12 mg/l by 55.4%. Peak concentrations of 20–40 mg/l were found in 83.2% of infants, and 15–60 mg/l in 99.0%. Highest peak concentration was 47.2 mg/l. Some 89.4% of infants with trough concentrations of 5–10 mg/l had a peak concentration of 20–40 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

This article has been cited by other articles:

				R K Crowley, F Fitzpatrick, D Solanki, S FitzGerald, H Humphreys, and E G Smyth Vancomycin administration: the impact of multidisciplinary interventions J. Clin. Pathol., October 1, 2007; 60(10): 1155 - 1159. [Abstract] [Full Text] [PDF]

				S Jain Role of serum peak levels of vancomycin in neonatal intensive care units Arch. Dis. Child. Fetal Neonatal Ed., September 1, 2003; 88(5): F445 - F446. [Full Text] [PDF]

eLetters: