Children may need higher vancomycin doses to achieve therapeutic levels.
To access publisher's full text version of this article click on the hyperlink below Aim: Vancomycin is frequently used in paediatric hospitals. Data suggest trough levels of 10-20 mg/L are needed to achieve bacterial killing. This study aimed to evaluate if commonly used dosing regimens are ef...
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Online Access: | http://hdl.handle.net/2336/621943 https://doi.org/10.1111/apa.16025 |
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ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/621943 2023-05-15T16:51:10+02:00 Children may need higher vancomycin doses to achieve therapeutic levels. Oskarsdottir, Kristin Haraldsson, Asgeir Thorkelsson, Thordur Oskarsdottir, Thorunn Gunnarsson, Petur Thors, Valtyr 1Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 2Children's Hospital Iceland, Landspitali University Hospital, Reykjavik, Iceland. 3Pharmacy department, Landspitali University Hospital, Reykjavik, Iceland. 4Faculty of Pharmaceutical Sciences, University of Iceland, Reykjavik, Iceland. 2021-11 http://hdl.handle.net/2336/621943 https://doi.org/10.1111/apa.16025 en eng Wiley https://onlinelibrary.wiley.com/doi/10.1111/apa.16025 Oskarsdottir K, Haraldsson A, Thorkelsson T, Oskarsdottir T, Gunnarsson P, Thors V. Children may need higher vancomycin doses to achieve therapeutic levels. Acta Paediatr. 2021;110(11):3077-3082. doi:10.1111/apa.16025 34233034 doi:10.1111/apa.16025 http://hdl.handle.net/2336/621943 1651-2227 Acta paediatrica (Oslo, Norway : 1992) ©2021 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd. Open Access - Opinn aðgangur Acta paediatrica (Oslo, Norway : 1992) 110 11 3077 3082 Norway children empiric treatment malignancy therapeutic drug monitoring vancomycin Börn Krabbamein Lyfjagjöf Article 2021 ftlandspitaliuni https://doi.org/10.1111/apa.16025 2022-05-29T08:22:39Z To access publisher's full text version of this article click on the hyperlink below Aim: Vancomycin is frequently used in paediatric hospitals. Data suggest trough levels of 10-20 mg/L are needed to achieve bacterial killing. This study aimed to evaluate if commonly used dosing regimens are efficient in reaching these levels and if therapeutic drug monitoring (TDM) was appropriately used. Methods: All children receiving intravenous vancomycin at the Children´s Hospital Iceland between 2012 and 2016 were included. Vancomycin trough levels were registered. Student t test, Wilcoxon test and regression models were used for statistical analysis. Results: A total of 105 children received 163 vancomycin treatments (55/105 neonates). Average daily dose in neonates was 23.4 mg/kg/day and 38.4 mg/kg/day for older children. No TDM was done in 58 treatments (35.6%). First trough levels were <10mg/L in 52.4% and <15mg/L in 92% of cases. Therapeutic levels were less likely achieved in children with malignancy (11.8%) compared with others (36.8%, p = 0.09). Conclusions: In more than half of the cases, trough drug levels were <10 mg/L and malignancy was associated with the lowest probability of reaching therapeutic levels. This study suggests that starting doses of vancomycin in children should be higher, especially in relation to malignant diseases and supports the importance of antibiotic stewardship to ensure optimal antibiotic use. Keywords: children; empiric treatment; malignancy; therapeutic drug monitoring; vancomycin. Article in Journal/Newspaper Iceland Hirsla - Landspítali University Hospital research archive Acta Paediatrica 110 11 3077 3082 |
institution |
Open Polar |
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Hirsla - Landspítali University Hospital research archive |
op_collection_id |
ftlandspitaliuni |
language |
English |
topic |
children empiric treatment malignancy therapeutic drug monitoring vancomycin Börn Krabbamein Lyfjagjöf |
spellingShingle |
children empiric treatment malignancy therapeutic drug monitoring vancomycin Börn Krabbamein Lyfjagjöf Oskarsdottir, Kristin Haraldsson, Asgeir Thorkelsson, Thordur Oskarsdottir, Thorunn Gunnarsson, Petur Thors, Valtyr Children may need higher vancomycin doses to achieve therapeutic levels. |
topic_facet |
children empiric treatment malignancy therapeutic drug monitoring vancomycin Börn Krabbamein Lyfjagjöf |
description |
To access publisher's full text version of this article click on the hyperlink below Aim: Vancomycin is frequently used in paediatric hospitals. Data suggest trough levels of 10-20 mg/L are needed to achieve bacterial killing. This study aimed to evaluate if commonly used dosing regimens are efficient in reaching these levels and if therapeutic drug monitoring (TDM) was appropriately used. Methods: All children receiving intravenous vancomycin at the Children´s Hospital Iceland between 2012 and 2016 were included. Vancomycin trough levels were registered. Student t test, Wilcoxon test and regression models were used for statistical analysis. Results: A total of 105 children received 163 vancomycin treatments (55/105 neonates). Average daily dose in neonates was 23.4 mg/kg/day and 38.4 mg/kg/day for older children. No TDM was done in 58 treatments (35.6%). First trough levels were <10mg/L in 52.4% and <15mg/L in 92% of cases. Therapeutic levels were less likely achieved in children with malignancy (11.8%) compared with others (36.8%, p = 0.09). Conclusions: In more than half of the cases, trough drug levels were <10 mg/L and malignancy was associated with the lowest probability of reaching therapeutic levels. This study suggests that starting doses of vancomycin in children should be higher, especially in relation to malignant diseases and supports the importance of antibiotic stewardship to ensure optimal antibiotic use. Keywords: children; empiric treatment; malignancy; therapeutic drug monitoring; vancomycin. |
author2 |
1Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 2Children's Hospital Iceland, Landspitali University Hospital, Reykjavik, Iceland. 3Pharmacy department, Landspitali University Hospital, Reykjavik, Iceland. 4Faculty of Pharmaceutical Sciences, University of Iceland, Reykjavik, Iceland. |
format |
Article in Journal/Newspaper |
author |
Oskarsdottir, Kristin Haraldsson, Asgeir Thorkelsson, Thordur Oskarsdottir, Thorunn Gunnarsson, Petur Thors, Valtyr |
author_facet |
Oskarsdottir, Kristin Haraldsson, Asgeir Thorkelsson, Thordur Oskarsdottir, Thorunn Gunnarsson, Petur Thors, Valtyr |
author_sort |
Oskarsdottir, Kristin |
title |
Children may need higher vancomycin doses to achieve therapeutic levels. |
title_short |
Children may need higher vancomycin doses to achieve therapeutic levels. |
title_full |
Children may need higher vancomycin doses to achieve therapeutic levels. |
title_fullStr |
Children may need higher vancomycin doses to achieve therapeutic levels. |
title_full_unstemmed |
Children may need higher vancomycin doses to achieve therapeutic levels. |
title_sort |
children may need higher vancomycin doses to achieve therapeutic levels. |
publisher |
Wiley |
publishDate |
2021 |
url |
http://hdl.handle.net/2336/621943 https://doi.org/10.1111/apa.16025 |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
Acta paediatrica (Oslo, Norway : 1992) 110 11 3077 3082 Norway |
op_relation |
https://onlinelibrary.wiley.com/doi/10.1111/apa.16025 Oskarsdottir K, Haraldsson A, Thorkelsson T, Oskarsdottir T, Gunnarsson P, Thors V. Children may need higher vancomycin doses to achieve therapeutic levels. Acta Paediatr. 2021;110(11):3077-3082. doi:10.1111/apa.16025 34233034 doi:10.1111/apa.16025 http://hdl.handle.net/2336/621943 1651-2227 Acta paediatrica (Oslo, Norway : 1992) |
op_rights |
©2021 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd. Open Access - Opinn aðgangur |
op_doi |
https://doi.org/10.1111/apa.16025 |
container_title |
Acta Paediatrica |
container_volume |
110 |
container_issue |
11 |
container_start_page |
3077 |
op_container_end_page |
3082 |
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1766041273704120320 |