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dc.contributor.authorKishk, O.A.
dc.contributor.authorLardieri, A.B.
dc.contributor.authorHeil, E.L.
dc.date.accessioned2019-07-15T16:16:58Z
dc.date.available2019-07-15T16:16:58Z
dc.date.issued2017
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85033440894&doi=10.5863%2f1551-6776-22.1.41&partnerID=40&md5=b3b0ae06916f90eb98eed663fa36baec
dc.identifier.urihttp://hdl.handle.net/10713/10027
dc.description.abstractOBJECTIVES Adult guidelines suggest an area under the curve/minimum inhibitory concentration (AUC/MIC) > 400 corresponds to a vancomycin trough serum concentration of 15 to 20 mg/L for methicillin-resistant Staphylococcus aureus infections, but obtaining these troughs in children are difficult. The primary objective of this study was to assess the likelihood that 15 mg/kg of vancomycin every 6 hours in a child achieves an AUC/MIC > 400. METHODS This retrospective chart review included pediatric patients >2 months to <18 years with a positive S aureus blood culture and documented MIC who received at least two doses of vancomycin with corresponding trough. Patients were divided into two groups: group 1 initially receiving ≥15 mg/kg every 6 hours, and group 2 initially receiving any other dosing ranges or intervals. AUCs were calculated four times using three pharmacokinetic methods. RESULTS A total of 36 patients with 99 vancomycin trough serum concentrations were assessed. Baseline characteristics were similar between groups. For troughs in group 1 (n = 55), the probability of achieving an AUC/MIC > 400 ranged from 16.4% to 90.9% with a median trough concentration of 11.4 mg/L, while in group 2 (n = 44) the probability of achieving AUC/MIC > 400 ranged from 15.9% to 54.5% with mean trough concentration of 9.2 mg/L. The AUC/MICs were not similar between the different pharmacokinetic methods used; however, a trapezoidal equation (Method A) yielded the highest correlation coefficient (r2 = 0.59). When dosing every 6 hours, an AUC/MIC of 400 correlated to a trough serum concentration of 11 mg/L. CONCLUSIONS The probability of achieving an AUC/MIC > 400 using only a trough serum concentration and an MIC with patients receiving 15 mg/kg every 6 hours is variable based on the method used to calculate the AUC. An AUC/MIC of 400 in children correlated to a trough concentration of 11 mg/L using a trapezoidal Method to calculate AUC. Copyright Published by the Pediatric Pharmacy Advocacy Group. All rights reserved.en_US
dc.description.urihttps://www.doi.org/10.5863/1551-6776-22.1.41en_US
dc.language.isoen_USen_US
dc.publisherPediatric Pharmacy Advocacy Group, Inc.en_US
dc.relation.ispartofJournal of Pediatric Pharmacology and Therapeutics
dc.subjectArea under curveen_US
dc.subjectChilden_US
dc.subjectMicrobial sensitivity testsen_US
dc.subjectPharmacokineticsen_US
dc.subjectStaphylococcus aureusen_US
dc.subjectTherapeutic drug monitoringen_US
dc.subjectVancomycinen_US
dc.titleVancomycin AUC/MIC and corresponding troughs in a pediatric populationen_US
dc.typeArticleen_US
dc.identifier.doi10.5863/1551-6776-22.1.41


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