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Constant rate infusion of vancomycin in premature neonates: a new dosage schedule
Author(s) -
Pawlotsky F.,
Thomas A.,
Kergueris M. F.,
Debillon T.,
Roze J. C.
Publication year - 1998
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1046/j.1365-2125.1998.00763.x
Subject(s) - vancomycin , medicine , loading dose , elimination rate constant , anesthesia , continuous infusion , pharmacokinetics , gastroenterology , staphylococcus aureus , biology , volume of distribution , bacteria , genetics
Aims Since vancomycin's bactericidal action has been shown to be time‐dependent, a constant rate infusion over 24 h might result in a better bactericidal efficacy. The purpose of this study was to define a new dosage schedule in prematures.Methods Two vancomycin 24 h constant rate infusion schedules were tested in two groups of neonates. Postconceptional age (PCA) was 27 to 41 weeks in group 1 ( n =24) and 28 to 51.5 weeks in group 2 ( n =29). Group 1 neonates received continuous infusion of 10 to 30 mg kg −1 day −1 , adjusted for PCA and weight. Group 2 was designed to take into account the significant relationship observed in group 1 between vancomycin clearance standardized on weight and PCA and consisted of a constant loading dose of 7 mg kg −1 followed by continuous infusion of 10 to 40 mg kg −1 day −1 adjusted for PCA and weight.Results Mean vancomycin serum concentration at steady state was 11±3.1 mg l −1 in group 1 and 15.4±6.2 mg l −1 in group 2. Fifty‐six percent of group 1 values vs 88% of group 2 values were between 10 and 30 mg l −1 at steady state ( P <0.01). Both regimens were well tolerated.Conclusion A loading dose of vancomycin followed by constant rate infusion of the appropriate dose adjusted for PCA and weight might improve vancomycin concentrations in neonates.