Clinical pharmacokinetics of vancomycin in the neonate: a review
Neonatal sepsis is common and is a major cause of morbidity and mortality. Vancomycin is the preferred treatment of several neonatal staphylococcal infections. The aim of this study was to review published data on vancomycin pharmacokinetics in neonates and to provide a critical analysis of the lite...
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| Format: | Article |
| Language: | English |
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Elsevier España
2012-07-01
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| Series: | Clinics |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322012000700021 |
| _version_ | 1811327257000542208 |
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| author | Gian Maria Pacifici Karel Allegaert |
| author_facet | Gian Maria Pacifici Karel Allegaert |
| author_sort | Gian Maria Pacifici |
| collection | DOAJ |
| description | Neonatal sepsis is common and is a major cause of morbidity and mortality. Vancomycin is the preferred treatment of several neonatal staphylococcal infections. The aim of this study was to review published data on vancomycin pharmacokinetics in neonates and to provide a critical analysis of the literature. A bibliographic search was performed using PubMed and Embase, and articles with a publication date of August 2011 or earlier were included in the analysis. Vancomycin pharmacokinetic estimates, which are different in neonates compared with adults, also exhibit extensive inter-neonatal variability. In neonates, several vancomycin dosing schedules have been proposed, mainly based on age (i.e., postmenstrual and postnatal), body weight or serum creatinine level. Other covariates [e.g., extracorporeal membrane oxygenation (ECMO), indomethacin or ibuprofen, and growth restriction] of vancomycin pharmacokinetics have been reported in neonates. Finally, vancomycin penetrates cerebrospinal fluid (range = 7-42%). Renal function drives vancomycin pharmacokinetics. Because either age or weight is the most relevant covariate of renal maturation, these covariates should be considered first in neonatal vancomycin dosing guidelines and further adjusted by renal dysfunction indicators (e.g., ECMO and ibuprofen/indomethacin). In addition to the prospective validation of available dosing guidelines, future studies should focus on the relevance of therapeutic drug monitoring and on the value of continuous vancomycin administration in neonates. |
| first_indexed | 2024-04-13T15:04:26Z |
| format | Article |
| id | doaj.art-8b8a2e6941db40eb924f5dac0b7fb6d9 |
| institution | Directory Open Access Journal |
| issn | 1807-5932 1980-5322 |
| language | English |
| last_indexed | 2024-04-13T15:04:26Z |
| publishDate | 2012-07-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-8b8a2e6941db40eb924f5dac0b7fb6d92022-12-22T02:42:13ZengElsevier EspañaClinics1807-59321980-53222012-07-0167783183710.6061/clinics/2012(07)21Clinical pharmacokinetics of vancomycin in the neonate: a reviewGian Maria PacificiKarel AllegaertNeonatal sepsis is common and is a major cause of morbidity and mortality. Vancomycin is the preferred treatment of several neonatal staphylococcal infections. The aim of this study was to review published data on vancomycin pharmacokinetics in neonates and to provide a critical analysis of the literature. A bibliographic search was performed using PubMed and Embase, and articles with a publication date of August 2011 or earlier were included in the analysis. Vancomycin pharmacokinetic estimates, which are different in neonates compared with adults, also exhibit extensive inter-neonatal variability. In neonates, several vancomycin dosing schedules have been proposed, mainly based on age (i.e., postmenstrual and postnatal), body weight or serum creatinine level. Other covariates [e.g., extracorporeal membrane oxygenation (ECMO), indomethacin or ibuprofen, and growth restriction] of vancomycin pharmacokinetics have been reported in neonates. Finally, vancomycin penetrates cerebrospinal fluid (range = 7-42%). Renal function drives vancomycin pharmacokinetics. Because either age or weight is the most relevant covariate of renal maturation, these covariates should be considered first in neonatal vancomycin dosing guidelines and further adjusted by renal dysfunction indicators (e.g., ECMO and ibuprofen/indomethacin). In addition to the prospective validation of available dosing guidelines, future studies should focus on the relevance of therapeutic drug monitoring and on the value of continuous vancomycin administration in neonates.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322012000700021PharmacokineticsVancomycinNeonateDevelopmental pharmacologyCovariates |
| spellingShingle | Gian Maria Pacifici Karel Allegaert Clinical pharmacokinetics of vancomycin in the neonate: a review Clinics Pharmacokinetics Vancomycin Neonate Developmental pharmacology Covariates |
| title | Clinical pharmacokinetics of vancomycin in the neonate: a review |
| title_full | Clinical pharmacokinetics of vancomycin in the neonate: a review |
| title_fullStr | Clinical pharmacokinetics of vancomycin in the neonate: a review |
| title_full_unstemmed | Clinical pharmacokinetics of vancomycin in the neonate: a review |
| title_short | Clinical pharmacokinetics of vancomycin in the neonate: a review |
| title_sort | clinical pharmacokinetics of vancomycin in the neonate a review |
| topic | Pharmacokinetics Vancomycin Neonate Developmental pharmacology Covariates |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322012000700021 |
| work_keys_str_mv | AT gianmariapacifici clinicalpharmacokineticsofvancomycinintheneonateareview AT karelallegaert clinicalpharmacokineticsofvancomycinintheneonateareview |