Assessment of Vancomycin Pharmacokinetics and Dose Regimen Optimisation in Preterm Neonates

• DOI: 10.1007/s40268-020-00302-7
• Publication Date: 2020-04-08T02:02:31Z
• Authors: Mwila Mulubwa; Heletje Aletta Gr...; Pierre Mugabo; Ricky Dippenaar; Lizelle van Wyk
• Keywords: Regimen; Therapeutic Drug Monitoring; Loading dose

The pharmacokinetics of vancomycin, a drug used for the treatment methicillin-resistant Staphylococcus aureus (MRSA), varies between paediatric and adult patients. objective this study was to assess vancomycin in preterm neonates determine optimum dose regimen. This randomised double-blind admitted neonatal intensive care units. They all received 15 mg/kg every 12 h. Blood sampled just before administration third, sixth ninth dose. Pharmacokinetic parameters were estimated using Bayesian approach implemented Monolix 2018R2 software. Covariates assessed included postmenstrual age, current weight, creatinine clearance, albumin, gestational body surface area age. We Monte Carlo simulations regimen optimisation targeting under concentration–time curve up 24 h (AUC0–24h) ≥ 400 mg × h/L. In total, 19 enrolled with median age 14 (3–58) days. A one-compartment model linear elimination best described vancomycin. Volume distribution clearance 0.88 L 0.1 L/h, respectively, typical neonate weighing 1.48 kg. Simulation showed that 27.5% would achieve target AUC0–24h h/L, 70.7% it 8 majority dosed. Vancomycin should be administered over 1 infusion improve likelihood achieving is considered optimal MRSA infections, where minimum inhibitory concentration ≤ µg/mL.