Background: Intermittent infusion of vancomycin is widely used to treat late-onset sepsis in neonates. On the other hand, the continuous infusion of vancomycin could improve bactericidal efficacy since its action is time-dependent.
Objective: To evaluate a simplified dosage schedule for continuous-infusion vancomycin therapy. Methods: Prospective study in premature neonates (<34 weeks) with suspected coagulase negative staphylococci (CoNS) sepsis. Before antibiotics at time zero (T0), serum creatinine was measured and blood cultures were collected. Vancomycin dosage began with 25 or 15 mg/kg/d (period 1) and 30 or 20 mg/kg/d (period 2) depending on whether serum creatinine was below or above 90 μmol/L. Two days after beginning treatment (first timepoint: T1), serum vancomycin was measured and second blood cultures were collected.
Results: Between June 2002 and December 2005, 145 neonates were evaluated. At birth, median body weight was 920 ([Q25, Q75]: [500, 1160]) g and gestational age was 28 [26, 29] weeks. At T1, serum vancomycin was within the required range in 74.5% of neonates (108/145). Serum vancomycin levels were higher in period 2 than in period 1 (20 mg/L versus 13 mg/L, p<0.05). At T0, 55% (80/145) of blood cultures were positive for CoNS, but 71% (57/80) were negative at T1. Four days after beginning treatment, 92% of subjects had recovered without removing the central venous catheter.
Conclusion: Using this simplified dosage schedule, bactericidal efficacy was maintained and most subjects had serum vancomycin concentrations within the therapeutic range.
Statistics from Altmetric.com
Review history and Supplementary material
The infusion concentration is stated to be 5 mg/l in the 6th line of the second paragraph on page F419. This should have read 5 mg/ml.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.